Unless you don't even have enough power to read this posting, you will by now have heard the story, watched the video, perhaps even posted a response or signed a petition about it: a four-year-old sneaks into a gorilla zoo enclosure, is grabbed by the adult male who slings him around through the water and into the concrete, and then is killed rather than euthanized in order to save the child's life.
Yes, however you look at it, it is a tragedy. It would be even if the gorilla weren't endangered. Beyond that, opinions abound. Some believe the zoo needs to beef up its barricades. They should have tranquilized rather than killed him. It's the parent's fault and they should be punished. Zoos shouldn't even exist. Whatever their answer to this, the solution for most everyone is one-dimensional, the answer either black or white.
Kinda like the gorilla, if you think about it. And that's the closest to levity you're going to get here.
I'm of many minds on this issue. Zoos can be either good or bad. It depends on animal treatment, the possibility of endangered species breeding programs, whether they can keep certain animals from going extinct, whether they teach respect, empathy and understanding among their visitors.
Barricades? Haven't seen them, nor how the kid got through, so I can't evaluate them here. I do know that there comes a certain moment in the young lives of certain individuals where any barricade becomes a challenge, mainly to demonstrate whether stupid is survivable or not. As they say on the news, alcohol is often a factor. But that's generally in older populations.
Tranquilizer? In an animal that size, it would take ten minutes to put him to sleep. Plenty of time to become more agitated, sit on the kid, drag him through more water, bash him against the walls more often and harder. The gorilla would have likely survived. The kid, not so much. The second that kid got in contact with an adult male gorilla, a tragedy was made. The only question then was how much the damage could be limited.
Yes, we all fondly remember the female gorilla a few years back who protected a young child who got into her enclosure. But remember: that was a female. In this case the females present with their young were swiftly persuaded to leave the enclosure. But how do you socialize the very epitome of raging macho when you have perhaps a minute or two to do something?
The trickiest judgment is whether it's the parent's fault. I have the most problems with this one. I raised one of those kids, always exploring, pushing boundaries, hard of listening, easily going off on his own. I got lucky. I actually raised one of those kids. All those trips to the ER, hunts through stores and crowds to find wherever he'd wandered off to this time just because my back was turned for a few seconds, and he still survived years past long enough to make me a grandmother. Perhaps he'll become a grandparent himself. He was my escape artist. Locks didn't keep him in, belts were quickly undone, discipline rolled right off his back and he was ready for next time. He's not the kid who drowned, the kid who ran into the street and got run over, the one who got trapped in the fire he experimented with.
WE WERE LUCKY.
Had I only raised the other two, the "good" kids, I'd probably find it easy to jump on the blame the parents bandwagon too. All the usual preventatives, the normal levels of attentiveness, the typical disciplines worked with those two, so obviously a kid who crossed the boundaries did so only with the negligence of their parents.
Right?
I have a distant in-law who earned himself a wheelchair for life by being one of those escape artist kids. He was buckled - properly - in his child seat in back when Mom heard funny noises. Just a quick glance behind her showed that he was well through the process of undoing his belts, and that was all it took for their car to hit another vehicle and snap his spine. Blame Mom? That's a hard one.
The news is full of stories of toddlers letting themselves out of the house in the middle of a freezing night, or into the family pool to drown because Mom/Dad/Grandma/babysitter lost sight for just a moment. Plenty of folks get their five seconds of fame dishing dirt on the local escape artist toddler + family, and/or opining that the justice system really needs to get involved.
I do get the other side of that issue as well. I judge plenty of other parents. Back when I was one of them, about the only other adults I had to talk to were other parents of toddlers. Mostly we talked side-by-side or even back-to-back, eyes peeled in all directions to see who was getting into what at any moment. I had a comfort level with how long a time I could actually do the polite thing and make eye contact with the other parent.
It's very like my comfort level with looking somewhere off the road while driving. Short. To give you an idea, many TV shows where conversation happens in cars drive me nuts because the driver keeps looking at the passenger rather than the road. "Bones" is a prime example. Not only would we watch our own kids while we chatted, we'd watch all kids and alert the parent when attention was needed. It still drives me nuts to talk to a parent when I'm the only one who has any idea what the kids are doing. So yes, I can judge, too.
I just need more information before I do it.
Monday, May 30, 2016
Better the Second Time
I've just been killing some time answering a question. I've had to go back through old blog postings, starting after March 2nd, the day of the first surgery. I know some things were worse the second time, and some things just seemed worse the second time, and some actually seemed better. I wanted to try to figure out what was real from what was well-medicated memory.
There are differences even with the medication. I started with a higher dosage, leaving the hospital, and taking those more frequently. It took a while to ease back and sort out a schedule, both. This time I had the 6-hour-thing already set, and added in the ibuprofin even earlier - I think - than before. But results have been a bit mixed, partly because starting points have been different, and partly, I'm told, because the second knee is just ... different.
I'm in better shape this time. Most of you might have been in worse shape this soom after the first knee, having to back off from old activity levels. In my case I has already backed off from activity levels so far that crossing the house itself made me feel ill before the first surgery. By the 10 weeks to the 2nd surgery I had developed some stamina as well as some strength. I could walk, for example, from wherever the car was parked all the way through to the PT waiting room without a couple stops on the way. I still needed / need the walker, but it's not a full 2 weeks yet. Patience! I am, however, looking forward to a quicker trip down the hall, or being able to carry a hot cup or plate with me from the kitchen. Or just a full one, any temperature.
(Note: I took an extra couple days before posting this - part ennui, part caffeine deprivation - to wait and make it exactly 2 weeks. Yesterday was still a bit soon. Still some walking pain, a bit of a wobble on a sudden corner after bumping the other knee. But today is just perfect, so yes, I'm again walker-free at the two weeks mark.)
The arms retained much of the strength gained from pushing my up out of a chair after the 1st knee, and quickly returned to needed strength. The habit had already been mostly lost, however, as at 10 weeks I was mostly rocking rather than pushing off to a stand. While I was getting back into automatic on that, I managed the second go-through to avoid hitting my head on the bathroom towel bar, strategically placed by the previous thoughtful owner in the exact space necessary to make that a challenge. Muscle memory!
While most of sitting/standing was better, there have been a couple new issues. There is a muscle clump on the back of that thigh which contains a nerve which pinches every time I sit quickly. Since most of my sitting on a toilet is done when I am in a hurry, this is a frequent problem. If I hold myself up off the toilet seat too long, other unwanted things occur. Standing is also still painful, but I have to keep reminding myself how short a time into the process it still is. It's quite likely I'm doing better than before.
I have PT later this afternoon. I will be getting ready by having my first real self-cleaning session at the kitchen sink. Yes, still keeping the incision area dry, still letting the counter handle my weight and balance for me. I think this is right on schedule from last time.
I hadn't noticed how much definition I either kept or quickly regained in the first foot. About all I had noticed those first couple weeks was how dirty it was, how long the ink stayed before getting washed off, how long it took to put my own sock back on. All I see so far are the differences in how puffy the second foot got in the first place. I referred to it as a fat sausage with tiny wiggly toes on the end. Now it moves internally, not just as a whole swollen tube; the toes seem to be emerging from the sausage, gaining in length, and those major bulges under which vessels and tissues hide are taking on definition. Not there yet, but progress. Since I can't compare it to the first surgery, this time I'll just happily be satisfied in its progress compared to itself. After all, not two weeks yet, remember?
Swelling on the whole was more widespread this time, I believe. I hadn't noted it much the first go round, so it's hard to compare, but I recall being surprised at how wide the whole joint was. Along with that, it seems to have been more difficult managing to bend it, but that can better be checked by comparing PT records. They're in my file, kept together as a whole, so I can ask. Where the pain is located is some different this time, complicated by that pinched nerve in my back since junior high being located on this side now. I have to be sure to lie down for short periods to ease that one, but at least I know the routine for it and add it into the home PT schedule accordingly.
(Another delayed info post: After checking all my numbers with my therapist, I find everything pretty much on track with last time. One kind of bend may be a degree off one way, a different one a degree off the other. Average is on schedule!)
It only took me a few days to be able to locate a comfy spot for the operated knee the first time through. It's still not happening, but I have the use of the lift chair for sleeping after giving up completely on finding something that works. While this is not what I'd call progress, I'm at least better prepared to deal with it, and by the time I have given up, the back is relaxed enough that the lift chair is again comfortable. I'n knocking this up to the first knee having something "normal" to bump up and snuggle against. The second knee is not finding that.
I'm using ice packs less this time around, and needing them less. I hope that's progress and not just stubbornness. Cold packs likely will regain their appeal as the summer heat, long delayed this spring, reaches back up into the three digits, forecast for early June now. I remember the packs cooling all of me down. Speaking of which, I am not having the problem - at least not yet - of being unable to control body temperature. How much of that was caused by which factors last time we may never know, but I'm aware and prepared, even to the drastic step of turning on the house AC. (Hey, had to do it 4X already this month!)
Back to those meds: the lower dose seems to be meeting my needs, though I add a half tablet back in the midnight dose to make it 7.5 to enable sleep. Back to the first time, nighttime doses were 10 with days at 7.5, and I do not know if that's what made the difference with side sleeping or if other factors were at work. I do know, reading back, that the side effects are lessened this go round. While dreams are still highly improbable, I seldom wake with the feeling of actually holding something in my hands. I'm doing much less subjective time-jumping, and what I do now is much more closely related to a few minutes of a nap than flashing out, flashing in.
I am getting better at recognizing the odd new symptoms as my body trying to tell me to take a nap. That can include sudden and subtle not-well-ness, restless legs, inability for make a 5 or 10 second short term memory. It was always just a feeling of tiredness, gritty eyelids, and I was off to Neverland: bing! Whether this is a long-term change or just from the meds remains to be seen. We'll also see if I can wake from what seems like a couple hours nap and find the clock taunting me with having moved only ten minutes. This too may be from the meds.
On the whole, what can be measured at this point seems to be the same or even better than last go-round. I'll settle for that. Staples come out Friday, the 2 1/2 week point, and I'm more than ready for a date with the pool!
And the shower too.
There are differences even with the medication. I started with a higher dosage, leaving the hospital, and taking those more frequently. It took a while to ease back and sort out a schedule, both. This time I had the 6-hour-thing already set, and added in the ibuprofin even earlier - I think - than before. But results have been a bit mixed, partly because starting points have been different, and partly, I'm told, because the second knee is just ... different.
I'm in better shape this time. Most of you might have been in worse shape this soom after the first knee, having to back off from old activity levels. In my case I has already backed off from activity levels so far that crossing the house itself made me feel ill before the first surgery. By the 10 weeks to the 2nd surgery I had developed some stamina as well as some strength. I could walk, for example, from wherever the car was parked all the way through to the PT waiting room without a couple stops on the way. I still needed / need the walker, but it's not a full 2 weeks yet. Patience! I am, however, looking forward to a quicker trip down the hall, or being able to carry a hot cup or plate with me from the kitchen. Or just a full one, any temperature.
(Note: I took an extra couple days before posting this - part ennui, part caffeine deprivation - to wait and make it exactly 2 weeks. Yesterday was still a bit soon. Still some walking pain, a bit of a wobble on a sudden corner after bumping the other knee. But today is just perfect, so yes, I'm again walker-free at the two weeks mark.)
The arms retained much of the strength gained from pushing my up out of a chair after the 1st knee, and quickly returned to needed strength. The habit had already been mostly lost, however, as at 10 weeks I was mostly rocking rather than pushing off to a stand. While I was getting back into automatic on that, I managed the second go-through to avoid hitting my head on the bathroom towel bar, strategically placed by the previous thoughtful owner in the exact space necessary to make that a challenge. Muscle memory!
While most of sitting/standing was better, there have been a couple new issues. There is a muscle clump on the back of that thigh which contains a nerve which pinches every time I sit quickly. Since most of my sitting on a toilet is done when I am in a hurry, this is a frequent problem. If I hold myself up off the toilet seat too long, other unwanted things occur. Standing is also still painful, but I have to keep reminding myself how short a time into the process it still is. It's quite likely I'm doing better than before.
I have PT later this afternoon. I will be getting ready by having my first real self-cleaning session at the kitchen sink. Yes, still keeping the incision area dry, still letting the counter handle my weight and balance for me. I think this is right on schedule from last time.
I hadn't noticed how much definition I either kept or quickly regained in the first foot. About all I had noticed those first couple weeks was how dirty it was, how long the ink stayed before getting washed off, how long it took to put my own sock back on. All I see so far are the differences in how puffy the second foot got in the first place. I referred to it as a fat sausage with tiny wiggly toes on the end. Now it moves internally, not just as a whole swollen tube; the toes seem to be emerging from the sausage, gaining in length, and those major bulges under which vessels and tissues hide are taking on definition. Not there yet, but progress. Since I can't compare it to the first surgery, this time I'll just happily be satisfied in its progress compared to itself. After all, not two weeks yet, remember?
Swelling on the whole was more widespread this time, I believe. I hadn't noted it much the first go round, so it's hard to compare, but I recall being surprised at how wide the whole joint was. Along with that, it seems to have been more difficult managing to bend it, but that can better be checked by comparing PT records. They're in my file, kept together as a whole, so I can ask. Where the pain is located is some different this time, complicated by that pinched nerve in my back since junior high being located on this side now. I have to be sure to lie down for short periods to ease that one, but at least I know the routine for it and add it into the home PT schedule accordingly.
(Another delayed info post: After checking all my numbers with my therapist, I find everything pretty much on track with last time. One kind of bend may be a degree off one way, a different one a degree off the other. Average is on schedule!)
It only took me a few days to be able to locate a comfy spot for the operated knee the first time through. It's still not happening, but I have the use of the lift chair for sleeping after giving up completely on finding something that works. While this is not what I'd call progress, I'm at least better prepared to deal with it, and by the time I have given up, the back is relaxed enough that the lift chair is again comfortable. I'n knocking this up to the first knee having something "normal" to bump up and snuggle against. The second knee is not finding that.
I'm using ice packs less this time around, and needing them less. I hope that's progress and not just stubbornness. Cold packs likely will regain their appeal as the summer heat, long delayed this spring, reaches back up into the three digits, forecast for early June now. I remember the packs cooling all of me down. Speaking of which, I am not having the problem - at least not yet - of being unable to control body temperature. How much of that was caused by which factors last time we may never know, but I'm aware and prepared, even to the drastic step of turning on the house AC. (Hey, had to do it 4X already this month!)
Back to those meds: the lower dose seems to be meeting my needs, though I add a half tablet back in the midnight dose to make it 7.5 to enable sleep. Back to the first time, nighttime doses were 10 with days at 7.5, and I do not know if that's what made the difference with side sleeping or if other factors were at work. I do know, reading back, that the side effects are lessened this go round. While dreams are still highly improbable, I seldom wake with the feeling of actually holding something in my hands. I'm doing much less subjective time-jumping, and what I do now is much more closely related to a few minutes of a nap than flashing out, flashing in.
I am getting better at recognizing the odd new symptoms as my body trying to tell me to take a nap. That can include sudden and subtle not-well-ness, restless legs, inability for make a 5 or 10 second short term memory. It was always just a feeling of tiredness, gritty eyelids, and I was off to Neverland: bing! Whether this is a long-term change or just from the meds remains to be seen. We'll also see if I can wake from what seems like a couple hours nap and find the clock taunting me with having moved only ten minutes. This too may be from the meds.
On the whole, what can be measured at this point seems to be the same or even better than last go-round. I'll settle for that. Staples come out Friday, the 2 1/2 week point, and I'm more than ready for a date with the pool!
And the shower too.
Thursday, May 26, 2016
You Want Me... For What?
This summer is time for my high school's 50th reunion. I'm already not enthused. Our family had relocated 200 miles just in time for the start of my junior year, a major jolt from small town to big city. The school I transferred into was itself accommodating a major meld when one local school closed down and its students split among two others. I was a newbie in a sea of newbies who already knew at least half the rest of their fellow students. Friendships had been formed, many for years and years.
Fortunately for my social life back then, I was in the band. Most of my friends and friendly connections came from there. It turned out to be a very short two years. A small handful of friends followed me to my chosen college, and from there we all scattered widely. My best high school girl friend Carol wound up on the deceased list a couple of reunions later, a victim of breast cancer. I hadn't known. The closest tie, if one can call it that, was with the girl who sat behind me in High School Junior English class who wound up marrying the man who, during college years, was engaged to my freshman roommate. Best thing to happen to both of them, and I always enjoy talking to Mary Ann and John at reunions.
Connections had gotten so sparse that reunions were about the only times anybody from high school ever contacted me. In fact, I found out that for a couple of reunions I was myself on the "cannot contact" list despite not having moved or changed my name for well over a decade. I wouldn't even have gone to the last one except for the fact that one long-lost classmate, Randy, called me up to verify I still had the same address from last time, and added his personal request that I attend so we could talk together.
I was amused to find that every time I came within 15 feet of him, he was "holding court", entertaining a whole cluster of people it was impossible to break through for a word, even had I been more inclined to work do so. Ah well.
One of the conversations I did get into was with the classmates charged with organizing the reunions. They were delighted to find out that I was still in the geographic area, suddenly finding me eminently qualified to assist them with their next reunion. This one. I recall smiling politely, saying something noncommittal, and excusing myself.
Frankly, I was astounded that they even claimed to know who I was. (Danged name tags!) In 52 years, high school to the present, they've never bothered to acknowledge that much familiarity, much less act on it, but suddenly somebody from the group is trying to contact me now. Nobody's familiar enough with me to know I retired, that I moved out of state, that I'm even still alive. They couldn't talk to me in high school, but now I'm sought after to help them organize their party of the decade.
The classmate who convinced me to attend the last reunion because he'd love to chat with me found a way to get in touch with my daughter to send along the message. He passed along that he'd love to chat with me there this time too.
Uh huh. I wonder if he even remembers he didn't even try to last time. Sure, Randy, I'd love to come. Maybe in another twenty years or so. Maybe, that is, if anybody there even cares. I'm totally not sure that I do. Well, that's kind of a lie. I'm pretty sure I have a strong opinion on the matter.
Fortunately for my social life back then, I was in the band. Most of my friends and friendly connections came from there. It turned out to be a very short two years. A small handful of friends followed me to my chosen college, and from there we all scattered widely. My best high school girl friend Carol wound up on the deceased list a couple of reunions later, a victim of breast cancer. I hadn't known. The closest tie, if one can call it that, was with the girl who sat behind me in High School Junior English class who wound up marrying the man who, during college years, was engaged to my freshman roommate. Best thing to happen to both of them, and I always enjoy talking to Mary Ann and John at reunions.
Connections had gotten so sparse that reunions were about the only times anybody from high school ever contacted me. In fact, I found out that for a couple of reunions I was myself on the "cannot contact" list despite not having moved or changed my name for well over a decade. I wouldn't even have gone to the last one except for the fact that one long-lost classmate, Randy, called me up to verify I still had the same address from last time, and added his personal request that I attend so we could talk together.
I was amused to find that every time I came within 15 feet of him, he was "holding court", entertaining a whole cluster of people it was impossible to break through for a word, even had I been more inclined to work do so. Ah well.
One of the conversations I did get into was with the classmates charged with organizing the reunions. They were delighted to find out that I was still in the geographic area, suddenly finding me eminently qualified to assist them with their next reunion. This one. I recall smiling politely, saying something noncommittal, and excusing myself.
Frankly, I was astounded that they even claimed to know who I was. (Danged name tags!) In 52 years, high school to the present, they've never bothered to acknowledge that much familiarity, much less act on it, but suddenly somebody from the group is trying to contact me now. Nobody's familiar enough with me to know I retired, that I moved out of state, that I'm even still alive. They couldn't talk to me in high school, but now I'm sought after to help them organize their party of the decade.
The classmate who convinced me to attend the last reunion because he'd love to chat with me found a way to get in touch with my daughter to send along the message. He passed along that he'd love to chat with me there this time too.
Uh huh. I wonder if he even remembers he didn't even try to last time. Sure, Randy, I'd love to come. Maybe in another twenty years or so. Maybe, that is, if anybody there even cares. I'm totally not sure that I do. Well, that's kind of a lie. I'm pretty sure I have a strong opinion on the matter.
Wednesday, May 25, 2016
Why You Got the Flag
It was a TV show, ending in a graveside military flag presentation. I've seen it countless times on TV and in movies. I've been there myself. This time I had a marginally different perspective.
The officer handing the folded flag to the grieving widow saluted. I wondered for the first time whether, when the recipient is a veteran, do they salute back? How about if they are active military? Did Steve salute when handed our father's flag? I was sitting right next to him and I didn't notice.
I do remember the decision to have the flag handed to him. It surprised me that there was even a question. Steve was the next generation veteran in the family and I just assumed that his was the honor and responsibility of receiving and caring properly for it. He'd do the job.
Today I realized it went further than that. I believe the only reason I was even in consideration for receiving it was that at the end our dad was living with me. If I thought anything about what was behind whether I should receive the flag, it would be that somehow I had "earned" it for taking care of him, at least in others' eyes. It wasn't that way in mine.
Steve was more than welcome to have the flag as a keepsake, as a way to remember and honor him that would be especially meaningful to him. I had those two extra years of memories and getting to know the young person our dad had been as he reverted back to his childhood as he failed, something to keep and honor him by.
The officer handing the folded flag to the grieving widow saluted. I wondered for the first time whether, when the recipient is a veteran, do they salute back? How about if they are active military? Did Steve salute when handed our father's flag? I was sitting right next to him and I didn't notice.
I do remember the decision to have the flag handed to him. It surprised me that there was even a question. Steve was the next generation veteran in the family and I just assumed that his was the honor and responsibility of receiving and caring properly for it. He'd do the job.
Today I realized it went further than that. I believe the only reason I was even in consideration for receiving it was that at the end our dad was living with me. If I thought anything about what was behind whether I should receive the flag, it would be that somehow I had "earned" it for taking care of him, at least in others' eyes. It wasn't that way in mine.
Steve was more than welcome to have the flag as a keepsake, as a way to remember and honor him that would be especially meaningful to him. I had those two extra years of memories and getting to know the young person our dad had been as he reverted back to his childhood as he failed, something to keep and honor him by.
Maybe You Gotta Scream First
A really weird thing happened on Monday, and the wheels started grinding. Not sure whether I hope my thoughts on the subject are correct or not. Not even sure which way I hope the turn out.
Let's start with that visit to the neighbor's house a couple months ago. Quick recap: terrible chair, terrible "help" getting out, extreme pain. The thing is, even though it kept hurting for a few days afater that, my knee actually gained mobility after that.
Now this Monday, this time in PT, as the neighbors back up are enjoying their Canadian cool. I was lying back on the table, knee bent, foot flat, trying to pull my foot nearer to my butt. What I felt was a progressive ripping in the tissues under the skin, just as if there was a zipper there getting pulled apart one piece at a time. The therapist was pulling rather than me doing the work, and when I yelled, she stopped. But she made me try it again, and I felt it again, just this time starting where it had left off and heading further down the leg. The next morning, I felt it again, lighter but the same sequential kind of ripping feeling, going a bit further down.
I haven't felt it since, though I've been a bit easing off on the PT for about 36 hours, simply in fear of it recurring. There is no particular residual pain there. No bruising or discoloration, no swelling. Nothing to indicate anything actually happened. But something "came apart" inside my knee. Perhaps it had to. Knowing there is no actual zipper in there, my first thought was that the staples had caught up a little something extra inside their grip. My second thought was to wonder if the word "adhesions" was applicable. I didn't bother to look it up.
I finally went back to fully pulling for the bend in the knee, no longer going easy on myself. I know that doesn't really help me long term, so back to work. It didn't repeat, so I figure whatever it was that was letting go, it did what it needed to. I think I'm getting that bend a bit better now. 90 degrees with elastic belt assistance was near impossible, and now my eye says its happening.
So I'm wondering just how much you need to push "past the point of pain" as they say on the PT instructions. In order to improve, maybe you just gotta scream first?
Let's start with that visit to the neighbor's house a couple months ago. Quick recap: terrible chair, terrible "help" getting out, extreme pain. The thing is, even though it kept hurting for a few days afater that, my knee actually gained mobility after that.
Now this Monday, this time in PT, as the neighbors back up are enjoying their Canadian cool. I was lying back on the table, knee bent, foot flat, trying to pull my foot nearer to my butt. What I felt was a progressive ripping in the tissues under the skin, just as if there was a zipper there getting pulled apart one piece at a time. The therapist was pulling rather than me doing the work, and when I yelled, she stopped. But she made me try it again, and I felt it again, just this time starting where it had left off and heading further down the leg. The next morning, I felt it again, lighter but the same sequential kind of ripping feeling, going a bit further down.
I haven't felt it since, though I've been a bit easing off on the PT for about 36 hours, simply in fear of it recurring. There is no particular residual pain there. No bruising or discoloration, no swelling. Nothing to indicate anything actually happened. But something "came apart" inside my knee. Perhaps it had to. Knowing there is no actual zipper in there, my first thought was that the staples had caught up a little something extra inside their grip. My second thought was to wonder if the word "adhesions" was applicable. I didn't bother to look it up.
I finally went back to fully pulling for the bend in the knee, no longer going easy on myself. I know that doesn't really help me long term, so back to work. It didn't repeat, so I figure whatever it was that was letting go, it did what it needed to. I think I'm getting that bend a bit better now. 90 degrees with elastic belt assistance was near impossible, and now my eye says its happening.
So I'm wondering just how much you need to push "past the point of pain" as they say on the PT instructions. In order to improve, maybe you just gotta scream first?
Thursday, May 19, 2016
Worse The 2nd Time Around
There are two levels here. The first may simply be a forgetting of the pain from last time. It is thus all subjective, yet none the less real. As this is now day 4, and walking is much more tolerable already, plus I am not fighting against taking the full dose recommended of pain meds for all those reasons I posted about earlier, I am much more willing to go with the subjective part of the evaluation.
Except for one very big thing. This time, coming out of the anesthetic, was the very worst experience I have ever had. And I've had plenty. I like to joke that all the spare parts have now been removed.
When I hit a new doctor's office and need to list previous surgeries, it's almost too long a list to remember, and definitely too long a list to keep track of the scientific names for. Tonsillectomy I can pronounce. Spell even. But there's a fancy term for what's more easily understood as gall bladder surgery. That's so far down my list that I've given up on trying to even remember how many syllables it has, much less what they are and how they are spelled.
All of that is in favor of establishing my street creds for being able to judge what is my worst time of it. So if you can accept my background for judging, let's scoot right on over to the details.
From the very first second of renewed awareness, it was bad. I've never gotten the "shakes" from anesthesia before. Just in case you cannot logically extrapolate from the expression, tensed up muscles increase pain exponentially. Relaxing is a wonderful gift, heretofore underappreciated. All that tissue severed and pulling against the stitches and staples trying to hold it back together so you don't spill out all over the floor... can we just settle for a unconditional statement of never wanting to go there again? Please?
I'm not sure just why it was different this time. Did they use a different dose? Different drug? Stop it at a slightly different time? I caught some background chatter about doing something different with the anesthesia once I was able to both feel the pain and recognize I needed to shake - like that was a choice? - and finally capable to move the right muscles to vocalize what was happening. I'm not sure if that background comment was actually about me, but people started moving around and dosing me with whatever, and after about 5 minutes it eased.
Five minutes is a very long time, unless you're eating very good chocolate ice cream. I wasn't.
I went back under for a bit after that, not remembering the actual lift and transfer into my room bed. That is a good thing, though it had an unintended consequence. I was not there to keep track of what was being done for me out of the list of things which were supposed to be getting done for me. Some of you will instantly recognize the phrase "it was shift change" and understand. I heard at least three different people tell me that ______ would take care of that for me as soon as he/she got in. I was trusting enough to accept that, or at least groggy enough not to fight against it.
Big mistake. There was an increasingly full bladder demanding attention as I would cycle around to consciousness again. There were pain meds that I was actually argued out of taking. Reasons I was given included it being too close to getting my next dose and not being as desirable a pain medication so maybe I really wanted to wait?
Seriously? My nurse is suggesting to me that despite my post-surgical pain (scale of 1 to 10, score 13) that maybe I really wanted to wait to get pain medication? Are you freaking insane? My reaction at that point is every twitch of my body screaming "Fix it! Fix it! Give me the strongest stuff you've got and if it makes me unconscious, so much the better right now!" Plus I know I'm going to have to get up to pee, as in walking to the toilet, and that's going to hurt even more if I'm not properly medicated.
One of the ways I react to anesthesia, and probably one they deliberately go for, is losing not just the ability to move myself around but the will to do anything. Think lobotomy. I'm simply not assertive. I may be screaming on the inside but it never reaches the throat. It's being conscious without there being a "there" there.
It lasts a while. I was awake enough to read the clock but not capable of doing anything to follow up on taking care of my needs for two whole hours. Yep: two hours!
When my nurse finally poked her head inside the door enough to give me her attention, and I was able to say something to her, I had a list!
Unfortunately, she got defensive. Now intellectually I can understand the chaos of shift change. I didn't need it to all crash down on me, however. I'm sure I wasn't all cheery, friendly, or smiley as I listed my issues, but then neither was I blaming, swearing, yelling, or bitchy - unless just the process of enumerating a list of issues comes across as bitchy. But I didn't either want or need excuses. I needed specific attention. And I finally got it.
Of course, the pain levels had been allowed to climb in the meantime, and it's much more effective to keep on top of them rather than have to play catch-up. Takes lower doses that way as well. But my much needed hike to the toilet was excruciating, so bad in fact that I wasn't sure I was even able to support myself without a fall. My escort just sort of rambled along next to me rather than observing that I was nearing the wrong side of coping. He also assumed aloud that I was capable of not only standing again but doing it steadily enough that I could safely wipe my own behind afterwards. You know, because that was when I should ring the bell pull for him to come back. Umm, did not do that so well. Scary. That experience encouraged me to delay the next few potty trips as well, exactly the opposite of what I should have been doing.
Contrast that with a pair of nurses that first night after doing the first knee who made sure I felt neither reluctance nor embarrassment about needing to be wiped those first times, and in fact offered should I need an assist. Oh, and made sure for the first two trips I was wearing a safety belt for additional support and they were on the other end.
I should note that by mid morning of day 2 I was just fine with coping, and by day 3 steady as a rock and impatient at needing to wait for my escort back to bed. But this was immediately post surgery. (Well, plus those two hours of delay.) My first hike. I really needed him for what he was supposed to be there for, that first time.
And apparently I was still not so good at being assertive.
Let me insert here that I should have asked for someone to be there with me when I woke up. Knowing I would be something less than company, I turned down offers. Turn back the clock to when I was 40 and had nobody to wait in the hospital with me. Kids in school or working, no boyfriend, etc. A good friend insisted that I really needed somebody to be there with and for me, and took a day off work to be that person for me. At the time I thought it was loving and very sweet of her to do. I never connected it to "necessary", not until now. So once I regained some semblance of my mind back, I called her up and let her know very belatedly how much that meant to me even though I hadn't a clue at the time. She would never have let two hours pass before somebody tended to a stated need of mine.
Thank you again, Joan.
Once my most pressing needs were taken care of, I was clear enough to hold an actual conversation with my nurse. I do respect nurses, and more, recognize how vital they are to what happens during my hospital stay. Together we could plan my meds schedule, basing it around not only the clock on the wall but the needs of PT so I could stand to do the exercises. We could schedule cleaning up and dressing, keep information flowing both ways. I wanted to be sure we two could work successfully and amicably as a team.
My cardiac meds unexpectedly became involved in a disagreement on the last day, as well. My BP was a bit low. They plan on your not taking BP meds on the day of surgery. That was fine. It can bottom out under anesthesia. They also delayed the timing of my metoprolol, but they'd done that with the first knee, explaining that morning meds just happened at 9AM for everybody, not 6 as in my home schedule. So I expected that as well. But then they were going to withhold, not just delay, the metoprolol, as well as the amiodarone, both of which I take to maintain cardiac rhythms. New-to-me nurse here, by the way.
I kept shaking my head and saying "no" as she listed each thing she wasn't giving me. I was also getting this look that told me she was finding me a difficult patient. It was not a look that indicated in any way that I would be getting my meds. Not even when I told her the two in my case were not just for BP but to maintain rhythm properly.
I suddenly had an epiphany. I had just set my kindle down as she'd walked in, and I keep two very important little strips of paper in its cover. So I switched the conversation around to having her acknowledge she knows how to read an EKG. Yes, she does. So I pulled the strips out so she could read for herself exactly what happened when I was not getting proper meds. They were the EKG strips taken in the ambulance on my ride to the hospital last summer. It impressed her enough that she let me know she no longer just thought I was being "anal" about my meds. Then after a quick check with the hospital doc who'd given the original order to withhold meds, I got the amiodarone back. Good enough compromise. I let her know I appreciated her following through on the matter for me.
There were other unsettling things about my first night. Obviously my brain wasn't working well, but I do recall that the list I had for my nurse had three things on it. I've no clue what the 3rd was. But the response I got was that it was something that I was supposed to have set up ahead of time, with time somehow defined as immediately after surgery but before now when I was functional. I still fail to understand just how whatever-it-was was supposed to be my responsibility when I was incapable of doing anything except feel a filling bladder and a knee that felt like a dozen knives had just sliced holes in it, nor did I recognize either name or function of the person I was to have set this up with.
It is remotely possible that item 3 on my list was a query about supper. It it was, I still don't see how I was supposed to have arranged it ahead of time. I did actually get my menu choices made in time for breakfast, and all following meals. I also thought I had not eaten the night before. However, while perusing the menu I read the details about one entry and could not only picture exactly how it looked on the plate, despite no picture in the menu, but knew how it tasted and felt in my mouth. I even recalled how much of it I had left on my plate!
Speaking of epiphanies, I have trouble fully communicating another one I had. There are two orthopedic wings in that hospital. One caters to "Joint Club" patients as first priority, the other to both the joint club overflow and to other post-surgical ortho patients. In theory, they should be identical. Either can take the overflow from the other as necessary, both combine into one when patient levels drop, same floor plan, both interchange staff.
However....
Having had two mirror surgeries in 10 weeks, one recovering in each wing, to me they were different. Possibly it is due to the two opposite kinds of wake-ups. But I found just enough difference in primary function, that despite their attempts to keep them the same there were differences. When you specialize in the exact precise thing that I need, and do that precise thing for and with everybody, you do it better and my needs are better met. It may be as little as 1/10th of a percent of difference, but it's there.
Normally when they shut down one wing, it's the joint club side they keep open. This time it was the medical-surgical side. Same staff for PT, exactly. Many of the same supporting faces from last time. I would just hope, because the differences are so subtle, that they continue to keep joint club open when they cut back. Make the open wing "joint club plus" rather than "orthopedic including joint club". Maybe it's as subtle as how the first trip to the bathroom gets handled. Or which clock takes priority over distributing meds due to PT scheduling. Or knowing whether and just how high to raise the bed before I get out or in, and which leg needs how much assist to change position, chair or bed. None of those things are huge. The difference they make is.
For all who were wondering, I am home, reasonably sane, partially capable. I still have a schedule that alternates about an hour of sleep with two awake, but sometimes it's the opposite. I can actually hear most of a question that's asked and process what's meant, and if it's a really good time, come up with an answer. I can almost watch a whole TV program without finding myself waking up to either commercials or a "Delete this?" box in the corner. Reading lasts about three pages. In short, I'm recovering. Call me in a day or two.
Except for one very big thing. This time, coming out of the anesthetic, was the very worst experience I have ever had. And I've had plenty. I like to joke that all the spare parts have now been removed.
When I hit a new doctor's office and need to list previous surgeries, it's almost too long a list to remember, and definitely too long a list to keep track of the scientific names for. Tonsillectomy I can pronounce. Spell even. But there's a fancy term for what's more easily understood as gall bladder surgery. That's so far down my list that I've given up on trying to even remember how many syllables it has, much less what they are and how they are spelled.
All of that is in favor of establishing my street creds for being able to judge what is my worst time of it. So if you can accept my background for judging, let's scoot right on over to the details.
From the very first second of renewed awareness, it was bad. I've never gotten the "shakes" from anesthesia before. Just in case you cannot logically extrapolate from the expression, tensed up muscles increase pain exponentially. Relaxing is a wonderful gift, heretofore underappreciated. All that tissue severed and pulling against the stitches and staples trying to hold it back together so you don't spill out all over the floor... can we just settle for a unconditional statement of never wanting to go there again? Please?
I'm not sure just why it was different this time. Did they use a different dose? Different drug? Stop it at a slightly different time? I caught some background chatter about doing something different with the anesthesia once I was able to both feel the pain and recognize I needed to shake - like that was a choice? - and finally capable to move the right muscles to vocalize what was happening. I'm not sure if that background comment was actually about me, but people started moving around and dosing me with whatever, and after about 5 minutes it eased.
Five minutes is a very long time, unless you're eating very good chocolate ice cream. I wasn't.
I went back under for a bit after that, not remembering the actual lift and transfer into my room bed. That is a good thing, though it had an unintended consequence. I was not there to keep track of what was being done for me out of the list of things which were supposed to be getting done for me. Some of you will instantly recognize the phrase "it was shift change" and understand. I heard at least three different people tell me that ______ would take care of that for me as soon as he/she got in. I was trusting enough to accept that, or at least groggy enough not to fight against it.
Big mistake. There was an increasingly full bladder demanding attention as I would cycle around to consciousness again. There were pain meds that I was actually argued out of taking. Reasons I was given included it being too close to getting my next dose and not being as desirable a pain medication so maybe I really wanted to wait?
Seriously? My nurse is suggesting to me that despite my post-surgical pain (scale of 1 to 10, score 13) that maybe I really wanted to wait to get pain medication? Are you freaking insane? My reaction at that point is every twitch of my body screaming "Fix it! Fix it! Give me the strongest stuff you've got and if it makes me unconscious, so much the better right now!" Plus I know I'm going to have to get up to pee, as in walking to the toilet, and that's going to hurt even more if I'm not properly medicated.
One of the ways I react to anesthesia, and probably one they deliberately go for, is losing not just the ability to move myself around but the will to do anything. Think lobotomy. I'm simply not assertive. I may be screaming on the inside but it never reaches the throat. It's being conscious without there being a "there" there.
It lasts a while. I was awake enough to read the clock but not capable of doing anything to follow up on taking care of my needs for two whole hours. Yep: two hours!
When my nurse finally poked her head inside the door enough to give me her attention, and I was able to say something to her, I had a list!
Unfortunately, she got defensive. Now intellectually I can understand the chaos of shift change. I didn't need it to all crash down on me, however. I'm sure I wasn't all cheery, friendly, or smiley as I listed my issues, but then neither was I blaming, swearing, yelling, or bitchy - unless just the process of enumerating a list of issues comes across as bitchy. But I didn't either want or need excuses. I needed specific attention. And I finally got it.
Of course, the pain levels had been allowed to climb in the meantime, and it's much more effective to keep on top of them rather than have to play catch-up. Takes lower doses that way as well. But my much needed hike to the toilet was excruciating, so bad in fact that I wasn't sure I was even able to support myself without a fall. My escort just sort of rambled along next to me rather than observing that I was nearing the wrong side of coping. He also assumed aloud that I was capable of not only standing again but doing it steadily enough that I could safely wipe my own behind afterwards. You know, because that was when I should ring the bell pull for him to come back. Umm, did not do that so well. Scary. That experience encouraged me to delay the next few potty trips as well, exactly the opposite of what I should have been doing.
Contrast that with a pair of nurses that first night after doing the first knee who made sure I felt neither reluctance nor embarrassment about needing to be wiped those first times, and in fact offered should I need an assist. Oh, and made sure for the first two trips I was wearing a safety belt for additional support and they were on the other end.
I should note that by mid morning of day 2 I was just fine with coping, and by day 3 steady as a rock and impatient at needing to wait for my escort back to bed. But this was immediately post surgery. (Well, plus those two hours of delay.) My first hike. I really needed him for what he was supposed to be there for, that first time.
And apparently I was still not so good at being assertive.
Let me insert here that I should have asked for someone to be there with me when I woke up. Knowing I would be something less than company, I turned down offers. Turn back the clock to when I was 40 and had nobody to wait in the hospital with me. Kids in school or working, no boyfriend, etc. A good friend insisted that I really needed somebody to be there with and for me, and took a day off work to be that person for me. At the time I thought it was loving and very sweet of her to do. I never connected it to "necessary", not until now. So once I regained some semblance of my mind back, I called her up and let her know very belatedly how much that meant to me even though I hadn't a clue at the time. She would never have let two hours pass before somebody tended to a stated need of mine.
Thank you again, Joan.
Once my most pressing needs were taken care of, I was clear enough to hold an actual conversation with my nurse. I do respect nurses, and more, recognize how vital they are to what happens during my hospital stay. Together we could plan my meds schedule, basing it around not only the clock on the wall but the needs of PT so I could stand to do the exercises. We could schedule cleaning up and dressing, keep information flowing both ways. I wanted to be sure we two could work successfully and amicably as a team.
My cardiac meds unexpectedly became involved in a disagreement on the last day, as well. My BP was a bit low. They plan on your not taking BP meds on the day of surgery. That was fine. It can bottom out under anesthesia. They also delayed the timing of my metoprolol, but they'd done that with the first knee, explaining that morning meds just happened at 9AM for everybody, not 6 as in my home schedule. So I expected that as well. But then they were going to withhold, not just delay, the metoprolol, as well as the amiodarone, both of which I take to maintain cardiac rhythms. New-to-me nurse here, by the way.
I kept shaking my head and saying "no" as she listed each thing she wasn't giving me. I was also getting this look that told me she was finding me a difficult patient. It was not a look that indicated in any way that I would be getting my meds. Not even when I told her the two in my case were not just for BP but to maintain rhythm properly.
I suddenly had an epiphany. I had just set my kindle down as she'd walked in, and I keep two very important little strips of paper in its cover. So I switched the conversation around to having her acknowledge she knows how to read an EKG. Yes, she does. So I pulled the strips out so she could read for herself exactly what happened when I was not getting proper meds. They were the EKG strips taken in the ambulance on my ride to the hospital last summer. It impressed her enough that she let me know she no longer just thought I was being "anal" about my meds. Then after a quick check with the hospital doc who'd given the original order to withhold meds, I got the amiodarone back. Good enough compromise. I let her know I appreciated her following through on the matter for me.
There were other unsettling things about my first night. Obviously my brain wasn't working well, but I do recall that the list I had for my nurse had three things on it. I've no clue what the 3rd was. But the response I got was that it was something that I was supposed to have set up ahead of time, with time somehow defined as immediately after surgery but before now when I was functional. I still fail to understand just how whatever-it-was was supposed to be my responsibility when I was incapable of doing anything except feel a filling bladder and a knee that felt like a dozen knives had just sliced holes in it, nor did I recognize either name or function of the person I was to have set this up with.
It is remotely possible that item 3 on my list was a query about supper. It it was, I still don't see how I was supposed to have arranged it ahead of time. I did actually get my menu choices made in time for breakfast, and all following meals. I also thought I had not eaten the night before. However, while perusing the menu I read the details about one entry and could not only picture exactly how it looked on the plate, despite no picture in the menu, but knew how it tasted and felt in my mouth. I even recalled how much of it I had left on my plate!
Speaking of epiphanies, I have trouble fully communicating another one I had. There are two orthopedic wings in that hospital. One caters to "Joint Club" patients as first priority, the other to both the joint club overflow and to other post-surgical ortho patients. In theory, they should be identical. Either can take the overflow from the other as necessary, both combine into one when patient levels drop, same floor plan, both interchange staff.
However....
Having had two mirror surgeries in 10 weeks, one recovering in each wing, to me they were different. Possibly it is due to the two opposite kinds of wake-ups. But I found just enough difference in primary function, that despite their attempts to keep them the same there were differences. When you specialize in the exact precise thing that I need, and do that precise thing for and with everybody, you do it better and my needs are better met. It may be as little as 1/10th of a percent of difference, but it's there.
Normally when they shut down one wing, it's the joint club side they keep open. This time it was the medical-surgical side. Same staff for PT, exactly. Many of the same supporting faces from last time. I would just hope, because the differences are so subtle, that they continue to keep joint club open when they cut back. Make the open wing "joint club plus" rather than "orthopedic including joint club". Maybe it's as subtle as how the first trip to the bathroom gets handled. Or which clock takes priority over distributing meds due to PT scheduling. Or knowing whether and just how high to raise the bed before I get out or in, and which leg needs how much assist to change position, chair or bed. None of those things are huge. The difference they make is.
For all who were wondering, I am home, reasonably sane, partially capable. I still have a schedule that alternates about an hour of sleep with two awake, but sometimes it's the opposite. I can actually hear most of a question that's asked and process what's meant, and if it's a really good time, come up with an answer. I can almost watch a whole TV program without finding myself waking up to either commercials or a "Delete this?" box in the corner. Reading lasts about three pages. In short, I'm recovering. Call me in a day or two.
Sunday, May 15, 2016
So, Are You Ready Yet? Huh? Are Ya?
Uhhh... maybe.
The real question is whether I'm ready for surgery tomorrow. Have I done all I need to? Am I mentally prepared?
Yes... and no. And/or no... and yes.
Obviously I've been here before, quite recently. I know what's coming, how to prepare. I also am aware of how much just can't be prepared for, and that's even when everything goes exactly as it should, no complications.
There's a bunch of stuff I won't be able to do for weeks afterward. Other that I can but won't want to. Of those, some things are done, some not. For example, I tried to save myself an extra trip to the pharmacy for a refill, but the insurance company says not yet. No problem with them if I refill while I'm actually in surgery, but....
I've tried to grocery shop ahead, but some will spoil while I'm not here and some things I'll suddenly decide I need during recovery. I've prepared with laundry - presuming I follow through with the load in the washer right now - and stuff is set out for getting packed in the morning. They've changed my surgery time three times now, but it's finalized so I know I'll have time for that without needing to set an alarm.
The pills I have to add to my routine have been added, and the ones I need to delete are stopped for now. WOW! Who would have believed how much of a difference in my pain levels and knee usage it made to have ibuprofin? Or how many times in this last week I could have taken note of that fact? And tomorrow, besides being NPO after midnight, I have to also delete my blood pressure meds from the daily dose so my BP doesn't drop too much under the anesthetic.
The house has gotten more of a cleaning that it got before the last surgery, including vacuuming. Which doesn't get done without including cussing, in turn. Sheets have been changed because the surgery department believes it matters the night before. Somehow they must think that my dryer sterilizes them, that they never touch anything on their way to being folded and unfolded as they travel from laundry to bed, that no dust wafts across the air currents, no dogs jump on the bed, and my before-bed special soap shower and clean PJ change also bring no germs into the environment, or at least that it's very different from doing it, say, yesterday.
Oh yes, I give myself another special-soap shower tomorrow morning before dressing in street clothes that somehow magically protect me from all microbes on my way in the (YIKES!) car to the surgery department.
Ahhh, optimists.
I've worked to watch all the backlogged TV shows on the DVR, catch up on bills, phone calls and emails as well as blog postings, petting the dogs to make up in advance for what they will miss, check out yard tasks (note I didn't claim to actually have done any), organize paperwork, etc. If I remember, I'll actually charge my cell phone and kindle tonight. I don't recall even feeling up to inquiring where I might charge them on my last visit. It was way more important to know how to use the nurse call for my assisted trip to the bathroom. Uh, trips. I never did figure out how to watch TV in the room. Nor care.
The physical equipment is still set from last time. Steve will switch our laptops to the opposite chairs for about three weeks until I'm no longer needing the services of the lift chair. Toiletries have been stockpiled, along with changes for dressings and other items I didn't know I needed the first time. PT appointments have been all scheduled, and the battle to convince Medicare that they are my primary insurer has been won. (Long story. Remind me.) I even ordered a toilet frame sent to Paul's house to assist with our time there. Being able to reach back and push off will still be much appreciated, and it's completely removable to fold and store for some other time.
Plans to close up the house for the trip north are being more solidified, starting with rejecting all the extra hassle involved if we decided I needed to fly back. First I'd need a new drivers license, requiring documents I don't have like an old marriage license to explain a name change. Then there are the papers assuring TSA that I'm not smuggling IEDs onto the plane inside both my knees. And so what if we decide it'll take an extra day or two to actually drive up when even those motel nights would still wind up costing less than the airfare? It may seem like I'm way ahead of myself with all that, but I have a good respect for how little mental effort I'll want to expend for several weeks and then will be too late.
There's still stuff I haven't done and won't. I was thinking about baking cookies. Scratch that. No floor mopping either. I don't care what the dogs have done there! There's still over a half tank of gas in the car, and an oil change will wait another month or two. What's it gonna be? An extra 100 miles? Pooper scoop? Let Steve! Seriously Steve, don't forget to scoop.
I do believe, though, that the most important question being asked within the umbrella of am-I-ready is whether I'm emotionally prepared for another round of surgery. The definitive answer is yes. And no. It's a mix of wishing to avoid the new pain levels I know await, particularly after having no ibuprofin to allow me enough comfort to roll over in bed right now to remind me just a bit what it'll be like. Plus knowing that the bone/joint pain will be gone very quickly when I start walking. It's wondering how much different it will be working with two replaced knees rather than one, and knowing how easy the recovery has been thus far with just one. It's finding out how it hurts to get in and out of the car after it didn't feel like that for nearly 2 months. It's knowing how great the hospital staff was the first time through the process.
And there's a last weird one in the mix. It's about the anesthetic creating a bit of retrograde amnesia so that I have no recollection of the chemical smells from the OR. Back when, 4 surgeries and nearly 30 years ago, what they used did not have that effect. Every time I entered a hospital for years after that - and there were a lot through work - I smelled those same chemicals and some visceral part of me recalled all the pain of that most recent surgery. When memory vanishes before leaving pre-op, starting up again with the transfer into my own bed in my room, that doesn't happen. So I don't have to brace myself for it.
So am I ready?
Maybe.
The real question is whether I'm ready for surgery tomorrow. Have I done all I need to? Am I mentally prepared?
Yes... and no. And/or no... and yes.
Obviously I've been here before, quite recently. I know what's coming, how to prepare. I also am aware of how much just can't be prepared for, and that's even when everything goes exactly as it should, no complications.
There's a bunch of stuff I won't be able to do for weeks afterward. Other that I can but won't want to. Of those, some things are done, some not. For example, I tried to save myself an extra trip to the pharmacy for a refill, but the insurance company says not yet. No problem with them if I refill while I'm actually in surgery, but....
I've tried to grocery shop ahead, but some will spoil while I'm not here and some things I'll suddenly decide I need during recovery. I've prepared with laundry - presuming I follow through with the load in the washer right now - and stuff is set out for getting packed in the morning. They've changed my surgery time three times now, but it's finalized so I know I'll have time for that without needing to set an alarm.
The pills I have to add to my routine have been added, and the ones I need to delete are stopped for now. WOW! Who would have believed how much of a difference in my pain levels and knee usage it made to have ibuprofin? Or how many times in this last week I could have taken note of that fact? And tomorrow, besides being NPO after midnight, I have to also delete my blood pressure meds from the daily dose so my BP doesn't drop too much under the anesthetic.
The house has gotten more of a cleaning that it got before the last surgery, including vacuuming. Which doesn't get done without including cussing, in turn. Sheets have been changed because the surgery department believes it matters the night before. Somehow they must think that my dryer sterilizes them, that they never touch anything on their way to being folded and unfolded as they travel from laundry to bed, that no dust wafts across the air currents, no dogs jump on the bed, and my before-bed special soap shower and clean PJ change also bring no germs into the environment, or at least that it's very different from doing it, say, yesterday.
Oh yes, I give myself another special-soap shower tomorrow morning before dressing in street clothes that somehow magically protect me from all microbes on my way in the (YIKES!) car to the surgery department.
Ahhh, optimists.
I've worked to watch all the backlogged TV shows on the DVR, catch up on bills, phone calls and emails as well as blog postings, petting the dogs to make up in advance for what they will miss, check out yard tasks (note I didn't claim to actually have done any), organize paperwork, etc. If I remember, I'll actually charge my cell phone and kindle tonight. I don't recall even feeling up to inquiring where I might charge them on my last visit. It was way more important to know how to use the nurse call for my assisted trip to the bathroom. Uh, trips. I never did figure out how to watch TV in the room. Nor care.
The physical equipment is still set from last time. Steve will switch our laptops to the opposite chairs for about three weeks until I'm no longer needing the services of the lift chair. Toiletries have been stockpiled, along with changes for dressings and other items I didn't know I needed the first time. PT appointments have been all scheduled, and the battle to convince Medicare that they are my primary insurer has been won. (Long story. Remind me.) I even ordered a toilet frame sent to Paul's house to assist with our time there. Being able to reach back and push off will still be much appreciated, and it's completely removable to fold and store for some other time.
Plans to close up the house for the trip north are being more solidified, starting with rejecting all the extra hassle involved if we decided I needed to fly back. First I'd need a new drivers license, requiring documents I don't have like an old marriage license to explain a name change. Then there are the papers assuring TSA that I'm not smuggling IEDs onto the plane inside both my knees. And so what if we decide it'll take an extra day or two to actually drive up when even those motel nights would still wind up costing less than the airfare? It may seem like I'm way ahead of myself with all that, but I have a good respect for how little mental effort I'll want to expend for several weeks and then will be too late.
There's still stuff I haven't done and won't. I was thinking about baking cookies. Scratch that. No floor mopping either. I don't care what the dogs have done there! There's still over a half tank of gas in the car, and an oil change will wait another month or two. What's it gonna be? An extra 100 miles? Pooper scoop? Let Steve! Seriously Steve, don't forget to scoop.
I do believe, though, that the most important question being asked within the umbrella of am-I-ready is whether I'm emotionally prepared for another round of surgery. The definitive answer is yes. And no. It's a mix of wishing to avoid the new pain levels I know await, particularly after having no ibuprofin to allow me enough comfort to roll over in bed right now to remind me just a bit what it'll be like. Plus knowing that the bone/joint pain will be gone very quickly when I start walking. It's wondering how much different it will be working with two replaced knees rather than one, and knowing how easy the recovery has been thus far with just one. It's finding out how it hurts to get in and out of the car after it didn't feel like that for nearly 2 months. It's knowing how great the hospital staff was the first time through the process.
And there's a last weird one in the mix. It's about the anesthetic creating a bit of retrograde amnesia so that I have no recollection of the chemical smells from the OR. Back when, 4 surgeries and nearly 30 years ago, what they used did not have that effect. Every time I entered a hospital for years after that - and there were a lot through work - I smelled those same chemicals and some visceral part of me recalled all the pain of that most recent surgery. When memory vanishes before leaving pre-op, starting up again with the transfer into my own bed in my room, that doesn't happen. So I don't have to brace myself for it.
So am I ready?
Maybe.
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