Wednesday, April 6, 2011

KNEE REPLACEMENT DIARY: DAY TWO

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.

Pain Assessment toolA 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.

Knee and leg sleeveWhen I called Odel at 7 am the day after surgery, with the help of Norco (a no doubt addictive pain killer), his pain level was One, almost non-existent.  Good news! 

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.

Bend that sucker!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.  :)

Still doing well.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!

20 comments:

  1. You feed that man all the fresh fruit he can eat! It would seem logical that the food in a hospital be healthy, but often that is not the case!

    So glad that Odel appears to be in good spirits, that the progress sounds promising, and that he isn't in alot of pain. Take care of both of you!

    Kerri in AL :-)

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  2. real food is always a welcome sight for a patient in the hospital!..glad to hear that Odel is coming along nicely!!..take care!..and we wish him a speedy recovery!!

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  3. We're following your every word on the progress. Good going, Odel. You'll be back on the golf course soon! ;->

    The food! ACK!!!! Gary was just in the hospital with pneumonia last week, and it was the [lack of] nutritious food that propelled him out ASAP! We can simulate a hospital environment here at home, and with healthier food!

    Progress is slow, but he is about 70% well now.

    Best wishes for a continued stupendous recovery!

    Virtual hugs,

    Judie (and Gary)

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  4. Odel appears to making an amazingly speedy recovery! Glad to hear he may be leaving the hospital today. The sooner out of a hospital, the better as far as I'm concerned.

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  5. I don't know if you remember bringing me a Harry and David box with all sorts of goodies when I was in the hospital, but it was the PEARS that looked like the most wonderful thing on earth to me. I had one immediately. (Hard to imagine that the cookies held NO appeal at all.)

    You would think by now all hospitals would be serving healthy food. Well, no more hospital food after today.

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  6. So glad to hear Odel and you are doing well. It will be nice to have Odel back home where he can get some actual sleep. Back home is also where it is important to keep up with the exercises. It's so easy to put them off. I know you'll be on him about doing them though. Make sure you are well rested too. You know what "they" say, you have to take care of yourself before you can take care of others. That is so true.

    And it sounds like you need to stock up on fruits and veggies. Hospital food is pathetically bad. I agree with everyone above that it always amazes us at how bad the food actually is. You would think they'd be more health conscience.

    Oh well, get him home safe and sound. We're thinking of you both.

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  7. Yea, you would think his diet might include fresh fruit, but I don't know of much hospital food that is 5 star....even 1 star!..This will change the minute Odel gets home and you get to cook for him....Looks like he is on the way!!

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  8. Be sure you tell the nurse what extra food you are feeding Odel as they keep track of ins and outs. I brought my own pop and they counted the cans I emptied.

    I actually had decent food at Methodist Hospital in St. Louis Park, Minnesota. I stayed there for my rehab after my double knee replacements so I was happy about the edible food. Lunch and dinner often came with a small tossed salad and dinner always had at least one vegetable and generally two. Most of the fruit was canned fruit but it did come with most meals and chilled canned fruit is one of my go-to foods when I don't feel well so I was happy with that. I think some hospitals feed you in a way that makes you want to heal faster. :)

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  9. Ya he needs that fruit to get his insides working again after the anesthesia. But I would suspect that he might be a tad bit spoiled with his diet from living with an eclectic cook, by the name of Laurie, LOL!!

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  10. Sorry to hear about the sub-par food. Where I had my total knee replacement surgery in Oklahoma City at the McBride Clinic Orthopedic Hospital, the food was like fancy room service. Plus the nurses let you have as much ice cream as you want!

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  11. So far, so good ~ or possibly I should say great? Well, except for the grub... But since his surgery had nothing to do with his digestion area I bet you can take him any thing he wants to eat without any worries from the hospital peeps!!!

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  12. Haven't heard any mention of peanut butter sandwiches yet.

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  13. Odel looks pretty happy in the pics! How about taking a homemade fruit smoothy to him in the morning? :)

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  14. Laurie this is a great series of posts on Odel's surgery and progress. I'm behind in reading my favorite blogs and am so happy to hear that he is doing great. Wish I could stop by and bring him a bag full of much better food.

    But by this time he's probably home and glad for it!

    Best wishes to you both!

    Sherry
    www.directionofourdreams.blogspot.com

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  15. Fruit, Vegetables, fiber fiber fiber. Norco will act as cement in the intestinal department, and Odel doesn't need to have that added to what is going on with his body! Hospital food: bland and not exactly created for um... regularity?

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  16. A homemade fruit smoothie would be good any time of day! He needs lots of fruit to counter some of the side effects of certain pain meds. Consult his doctor about how much he can eat though.

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  17. We have followed your blog for a long time and always enjoy your writing and photos -- we are so glad to hear of Odel's successful surgery and I am sure he will have a quick recovery (especially with all your competent help!) Take care!!

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  18. So happy Odel has reached such a good range of motion already. I'm sure you will be a great motivator to his recovery.

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  19. Glad to hear all is going well. Odel will be out on the golf course in no time at all!!

    Donna

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  20. Great to read that Odel's surgery has been completed and he is well on the road to recovery.

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