Two weeks before his surgery, Odel and I attended a two and a half hour long class about knee and hip replacement, offered by Sutter General Hospital. Among the many aspects of the surgery covered in this useful class, there was much emphasis on the importance of pain management. They introduced us to an easy to remember pain management graphic illustrating the 0 to 10 scale of pain.
A smiley face represents Level Zero – no pain. Around Level Four – starting to hurt consistently, but still manageable – the smile turns into a flat line… pain is intruding into well-being. By Level Eight, the expression is quite dismal and at Level Ten, all hell has broken loose – big frown with copious tears.
Ideal pain management means taking another pill as you approach level Four, the flat-line mouth. EVERYONE stresses the importance of staying “ahead of the pain”, which allows you to take LESS pain medication and to participate fully in rehabilitation, which begins the day of surgery.
I arrived at room 4101 around 10 am, practically running into Ron Ulm who was wrapping up another visit to Odel (Ron works at Sutter). Odel had already been seen by Dr. Bargar (surgeon), Dr. Tak (primary care physician), and Brian, Dr. Bargar’s assistant. As I took a seat, in walked Douglas, the physical therapist. No rest for the weary (which Odel was, after being awakened every two hours during the night) - time to get to work on therapy again!
Both of Odel’s legs were wrapped in long, pulsing sleeves that help prevent blood pooling and clots. Doug removed the sleeves and got to work bending and straightening Odel’s leg. Both Odel and Doug moved slowly, their faces reflecting concern over possible pain… which never materialized. Before long, Doug had Odel sitting on the side of the bed, and soon he was up, walking slowly around the room with his walker.
Once again, Doug emphasized range of motion and the importance of exercising the knee to improve its range. Walking, other than “functional walking” (as opposed to recreational walking), is discouraged because it promotes swelling, the enemy of range of motion. Sitting around with bags of peas on and under the knee to fight swelling is good; going for a pleasure walk in the springtime sunshine is bad.
Doug introduced us to the goniometer, a little plastic gizmo that measures the angle of bend in the knee, and was impressed to find that Odel could already bend his knee at a 92 degree angle.
After practicing with his walker, Odel sat in a chair while we talked with Doug about living in an RV, favorite places (Doug is very interested in paranormal activity, and entertained us with a few stories of strange encounters while staying overnight at the Copper Queen Hotel in Bisbee), and the problems we might encounter when Odel comes home (currently anticipated to be Wednesday afternoon).
When the work was finally done, Masial, the nursing assistant from Panama, arrived with a warmed pack of wet wipes and I was able to give Odel a sponge bath. We pulled the curtain across the entry and got to enjoy some private time. It felt good to me to do something useful and intimate, and we both laughed over the moaning noises Odel made as I scratched his back with fingernails wrapped in a soft, warm wet wipe. After he was dressed in a fresh hospital gown, Masial returned to change the sheets on his bed and he brushed his teeth. At last, he was presentable for his photograph. :)
I took off to continue preparing for his return (mainly, setting up a place for him to sit with the kind of easy access and support he needs). Our good friend Becky took Odel a Diet Pepsi (for which they share a fondness), and calls came in from various friends. Douglas returned for the afternoon therapy and exercise session and the goniometer showed an improvement, from 92 to 95 degrees. When I called at 4 pm, Odel sounded groggy – he told me he was just drifting off to sleep, very difficult to come by in the busy hospital environment.
So far, only one aspect of his care has been less than optimal: the hospital food! Breakfast was cream of wheat (which Odel hates), dry (overcooked) scrambled eggs, a slightly warmed English muffin, apple juice and milk. No fruit, fresh or otherwise. Lunch was an open faced turkey sandwich with mashed potatoes and gravy and – finally – some steamed vegetables. Where are his minimum five fruits and vegetables each day? When I pulled out an apple to eat while I visited, Odel’s eyes grew big, round, and expressive. Something fresh, juicy and crunchy! We shared it, and I’m gonna take some REAL food on my next visit!