My Trip to the Doctor

The bad news is that I’m wearing out. The good news is that there are replacement parts.” That’s how I told my family and friends that the knee I thought would recover from an arthroscopic surgery was never getting better. The new surgeon that I’d consulted, after months of pain and agony that left me almost lame, told me I had only one option – when to schedule knee-replacement surgery.

The news was a little daunting for a 50-something who usually moves around at the speed of light and leads a very active life. It didn’t help to learn that this kind of surgery is becoming commonplace for my generation. Or that tens of thousands of the generation before mine have already had the surgery. No, it didn’t help. I was scared and depressed and felt incredibly old and feeble.

That’s when my friend Richie helped put it in perspective for me: “Anyone who has led as many conga lines and danced on as many tables as you have deserves a new knee.”

I clung to that joke and decided that anything was better than not being able to get around – or shop! So, with Dr. David Ott – a highly recommended and tested surgeon who was recognized last month in this magazine as a “Top Doctor” – I bravely went “under the knife.” And that began my very interesting journey into Arizona’s healthcare system.

Morphine is my drug of choice. It can erase the most horrendous of pain. It makes you happy when you should be screaming in agony. And it lets you sleep when your entire body is traumatized. I really feel sorry for those who can’t tolerate the drug or are afraid of it. I loved my intravenous morphine drip, and the button I could push whenever I wanted more. I realize that some people think it’s brave or noble to experience pain, and they’re always preaching restraint to avoid getting “hooked.” I think those folks are misguided. I know how brutal the surgery was on my knee, and there was absolutely no way that I was going to skimp on morphine. As a result, my first three days at Good Samaritan Hospital in Phoenix were very, very happy.

Millie Bann helped. She was the first RN I saw as I came up from surgery. I immediately got the sense that I was in competent and skilled hands. Carla Milam helped, too. She’s a nurse’s assistant who went out of her way to make me feel safe and secure. Victoria Russell and Janet Siglow epitomized what good nurses should be.

And when it came to the dreaded physical therapists – the ones who get you out of bed right away and demand that you do impossible things like walk – well, I could not have asked for any better than Amber Zimmer, Alice Nichols, Judy Johnson and Chris Leal. In addition to all them, caseworker Nancy Barnett went out of her way to make sure I was on the road to recovery.

Of course, each one of them was well trained, and knew how to perform their jobs, but patients really don’t care much about that. What patients care about is something that can’t be taught in school – “bedside manner.” We’re so scared, and we’re fighting such awful pain, that what we need at that moment is someone who makes us feel safe. The women and men who can do that are ideal, those who can’t should look for another profession.

I took a little notebook with me to the hospital and made this note on the fifth page: “Good Sam can brag about a lot of things, but certainly not about its food.” Thankfully, the morphine and the other pain medications took away my appetite, so I didn’t care that most of the food delivered to my room was a little bland. But there’s no need for this, and I would hope that Good Sam would take a long, hard look at its kitchen.

A couple pages later in my notebook was a list of “patient improvements” that I hope will provide guidance to hospitals throughout Arizona:

• Provide a way for patients to get a daily newspaper. There used to be “candy stripers” who did nice things for patients, but, unfortunately, they’ve disappeared. Nurses and aides are too busy for the little stuff, but it’s important for patients to stay as connected as possible with the “normal” things in life.
• Hospitals need better television. Somebody at Good Sam thought people confined to their beds after surgery would want to see medical shows – some devoted to the “inside story” of horrible diseases and injuries. Yuck! Don’t hospitals know about cable television? You’d think that they’d have caught on to “pay per view” by now.
• Please know that sometimes the simplest of things can cause a lot of problems. For example, a friend was in another hospital around the time of my surgery when the tape over his incision was ripped off, leaving him with torn skin that was more painful than his surgery.
• I really appreciated the class I attended at Good Samaritan before my surgery, where nurses filled us in on exactly what would happen and what to expect. I’m told that not all hospitals do this. They should.

I also noted a few things that doctors should tell their patients before surgery:

• I knew enough to start isometric exercises on both legs two months before my surgery, but no one ever mentioned how important my arms would be. You have little but your arms to help you the first days after surgery, and I was horrified to learn that mine were so weak. Doctors should insist that patients start working on their upper-body strength the minute they know they need surgery.
• No one bothered to mention that between the anesthesia, morphine and pain pills, your brain gets addled. So, it comes as a real shocker that you have no interest in reading books, can’t do a crossword puzzle, and have to read newspaper stories again and again just to understand what they mean. (This temporary impairment is one of the reasons they don’t want you driving for at least a month after surgery.) I’d taken a pile of books to the hospital, which collected dust. Not only that, I’d intended to write a children’s book during my recovery. Ha. Doctors should inform people about the side effects so they don’t freak out.
• Patients should be told that they’re going to have no energy for at least a month – every ounce of energy is put into healing. Doctors could relieve a lot of anxiety if they just shared this information. The good news, however, is that you’re going to come out of this experience with a new view on life. When you have to deal with something as basic as going to the bathroom, it does something to your sense of what’s important in the world. I think this is a good thing.

I remember recoiling the first time Dr. Ott suggested I go to a rehab facility after the hospital – all I could envision was a nursing home, and I knew I wanted nothing to do with that. I had intended to stay with friends, but Dr. Ott assured me that a rehab facility would give me the intensive therapy I’d need to recover. And, make no mistake about it – rehabilitation is the name of the game in knee surgery. You can have a Top Doc like Dr. Ott, but if you don’t do the rehab work, you’re not going to get your knee back.

For rehab, I went to HealthSouth at 96th Street and Shea in Scottsdale, part of the nation’s largest rehabilitation network, and I couldn’t have asked for better care.

HealthSouth schedules three hours of therapy a day, but I managed to get four hours, including a therapy pool that was absolute heaven. The staff is young and wonderful – they pushed but didn’t shove – and I made incredible progress in the three days I spent there. Most patients stay a week to 10 days, but I worked extra hard so I could get home, where I enjoyed one of the most joyful weekends of my life.

My pals at the Phoenix Firefighters Association – from President Billy Shields to member’s services director David Fisher – were like big brothers, anticipating what I’d need to recover. They loaned me a hospital bed for my living room, along with a “lift chair,” plus, their frequent visits and cheerleading really helped.

In addition, my friend Mary Perret came from San Diego to spend a week with me. And longtime friends went out of their way to care for me, including Marge Injasoulian, Nan and Dave Robb, Athia Hardt, Marge Rice, Cathy Eden, Kenn Smith, Tommy Martinez, Mary Ellen Brown, Marcia Craven, Sally Joseph, Jay Goodfarb, Gail Adams, Linda Weaver and Jim Ballinger. With my friends gathered around me – drinking wine, watching movies, catching up on the news, filling me in on the latest shenanigans at the Legislature – I lay on my hospital bed with my leg in a “Continuous Passive Motion” machine that had been my constant companion since surgery. (Here’s a hint: If your surgeon does not believe in CPM machines, run, don’t walk, out of that office and find a new surgeon. These machines shouldn’t be an option when it comes to your recovery.)

I know some people have had horrible experiences with this surgery, and their recovery has been awful, but that’s the opposite of what happened to me. One reason is this: I embraced the realization that I’d have a good knee again, and whatever pain or discomfort it took to get me there was worth the price. So, I stayed cheery and optimistic the whole time.

The next Monday, I started outpatient therapy at Arizona Sports & Physical Therapy at Palm Lane and Central. It’s so close to my house that if I were able to walk, I could have walked there. But I couldn’t walk.

I couldn’t drive, either, so my friends took me to therapy three days a week for a month. Some patients choose home therapy instead of outpatient therapy, but I was glad I chose the latter – I felt I got more of a workout, and besides, it got me out of the house so I didn’t go stir crazy.

In fact, I loved going to therapy – Gary Derscheid and Andrea Dunn were wonderful in getting me back on my feet. At first, we spent an hour each day doing stretches and bends. But after two weeks, we added another hour of pool therapy each day.

The day I could abandon the walker was a real red-letter day. After that, I used a cane for a couple weeks. Eventually, I was strong enough to walk on my own – with a brand-new knee that doesn’t hurt anymore.
It’s an amazing thing what great doctors, nurses, therapists and friends can do. They can give you back your life.