Wednesday, March 16, 2011

Hospitals - Another World

Whenever I have to spend time in a hospital, I remember how strange it is.  It isn't part of  "the real world" (whatever that is). Unless your bed is placed just so and someone leaves the privacy curtains open, you don't know what time it is; the clocks there are for the staff's convenience, not yours, and they don't let you wear a watch.  Also, unless you're very lucky in your bed placement, you don't have a window available; all the light is artificial light, and I couldn't turn mine on or off.  Casinos are the other place where clocks and windows aren't common; and that's just such a strange comparison that it makes me shake my head.

You have very little control in a hospital.  I learned this time that you can actually refuse a drug.  A couple of my normal prescriptions say twice a day when a later verbal agreement with the doctor has reduced it to once, and they were OK with that; but they always tried to give me the second dose.  And of course, if you have an IV, you get whatever it's delivering.  They're acutely careful about drug allergies, but other allergies don't get much attention. I'm allergic to the adhesive on the paper tape they use, and I have half a dozen rectangular, itchy rashes where I had things taped to me while I was unconscious.  And of course, there's the "hospital gown," a total symbol of subservience!

You certainly have no control over roommates.  I was lucky this round, my "worst" roommate was the woman who snored like a sawmill and spent endless hours on the phone.  (She got phone calls for a day and a half after she was discharged.)  But in previous stays I've had roommates who:
  • Complained constantly and loudly to everyone in earshot about the awful treatment she was getting, including to the largest collection of visiting relatives I've ever seen, all of whom stood around for hours and encouraged her to rant and threaten to sue.  The staff eventually gave her a private room, I think because her relatives were causing traffic problems.
  • Went totally off the rails and tried to remove an IV stent embedded in her neck.  Older woman, concluded that the nursing staff were all dope dealers and were trying to kill us.  She then tried to remove the stent herself - I was terrified her jugular vein would come out with it.  I've never pressed a call button with such energy!  The nurses removed her to another room.
  • Threw a world-class, CAT-5 temper tantrum.  This was during my stay over Thanksgiving week in 2005, when the hospital was (shall we say) understaffed; call buttons were answered in maybe 15 minutes if you were lucky.  This older woman of Middle Eastern extraction (I met her son) was screaming, cursing in multiple languages, throwing things at people, throwing food and food trays on the floor, because she wasn't getting the response she thought she deserved.  I asked the charge nurse if one of us could be moved to another room and thank God, they moved her.
My roommates this time were much less, um, startling. In fact, they were all quite nice.  But it is very odd to talk to someone through a privacy curtain all day and then discover that she thought you were someone else.  I was moved into the 3 bed room at 6 AM, and she thought I was the woman who'd been there the day before!  I finally saw this woman's face on the second day, shortly before she went home.

Hospitals aren't silent, even in the middle of the night. Your IV pump (or your neighbor's), clicks steadily away.  I told one nurse it was an "irregular" noise and she said no, it's very regular; and I explained that it wasn't musically regular.  And I had another personal pump, since my surgery carried the risk of deep vein thrombosis - they put velcro wrappers on my calves which massaged them alternately with air pressure, around the clock. I got used to it, but at first, I'd be just dozing off,  no one else in the room, and something would start rubbing my calf.  It woke me up.  And when it finishes a cycle, it expels the air with a sigh that sounds just like a person.  The first night, I kept thinking it was me sighing and it actually affected my breathing (I was pretty stoned).

The hospital bed wasn't too bad, but the pillows were terrible.  The hospital bought pillowcases that were too small for the pillows, so nice puffy looking pillows, rammed with effort into the cases, became rock-like lumps, impossible to sleep comfortably on.  I understand why they run things that way; but frankly the less time I spend in the hospital, the happier I am. 

Monday, March 14, 2011


Several people have kindly asked about the outcome of my knee replacement surgery, so here is the status.

The operation went well, I came home from the hospital last Friday, and I'm currently doing rehab at home under supervision from the Kaiser Home Health Care team.  The surgeon said the xrays look very good.

The amazingly good news is my low pain level.  Anyone who's ever replaced a knee winces at the thought of the rehab exercises, especially in early days.  My surgical team used a new procedure called a femoral nerve block:  they insert a tiny catheter in the leg and feed painkillers just to the femoral nerve.  I came out of anesthesia with a pain level of zero in the operated leg; I couldn't believe it.  They leave the nerve block in place for about 2 days, during which you rest quietly and have basically no pain at all.  When they remove it, your pain level is still MUCH lower than what I used to consider "normal."  I will probably be able to get through rehab with only a couple of narcotic doses per day, to let me exercise; when I'm resting, I don't need narcotics at all.  I can't praise this new method enough.  In both earlier surgeries I took narcotics around the clock for several weeks.

I'm less sure about my long-term prognosis.  There was more damage than we hoped, and one leg is now slightly longer than the other.  But each day my leg feels stronger and more stable, and I'm feeling more and more positive at least about the near term.  Many thanks to all my friends who have asked about my status, and sent good wishes my way!

Monday, March 07, 2011

The Seven Faces of Dr. Lao

We finally got around to watching this movie, which I chose on a whim from Netflix.  I can't recommend it enough; it's amazing on multiple levels.  This 1964 production stars Tony Randall in at least eight distinct roles (each with different makeup and costuming), plus at least four different interpretations of the mysterious "Dr. Lao" (pronounced "Low", if you please).  You've never seen a Western like this.  There are no gunfights (although there's a little rough-housing); as many people ride bicycles as ride horses.  It's about a small town, which the local rich man wants to buy up; it's about a fighting newspaperman and a lovely widowed librarian with a plucky little boy.  And it's about the Circus of Dr. Lao, who rides into town one day on a donkey, with a goldfish bowl containing a catfish balanced on his saddlebow, and buys full-page ads in the newspaper... 

If I tell you any more I'll blow the plot, which would be a shame.  You can look it up on IMDB if you're curious.  But the camera work is marvellous, the acting is good (Tony Randall is better than good) and the special effects -  wow.  George Pal, the director, used to work with Ray Harryhausen.  Harryhausen didn't work on this film, but I've seen some of the films he did, and this one is a match for any of them.  It got an Oscar nomination for Best Effects, Special Visual Effects, but was beaten out by Mary Poppins.  I've seen both films, and I'm not sure I buy the vote.  Rent this one and treat yourself to a magical evening.

Sunday, March 06, 2011

Waiting for Surgery

I'm in a strange, limbo-like state.  In two days, on Tuesday March 8, I will get my left knee revised - that's the word they use when they have to take out an artificial knee and put in a new one.  I'm bored; I've had to stop all my usual activities, because for at least 3 months after Tuesday, my primary activity will be rehabbing the new knee.  Having done this twice before, I'm not looking forward to it.  I've also had to stop all my NSAID pain pills for the last 3 weeks, because any trace of them makes bleeding worse; and trust me, acetominaphen (generic for Tylenol for those who don't read the fine print) is not an acceptable substitute.

I also feel betrayed.  I was told these things were supposed to last 15-20 years; this is just over 5 years.  I've recently discovered there are at least three recall actions out on three different artificial knee implants, from two different manufacturers.  And I don't know whether they affect me or not, because when the failing implant was put in, I didn't ask what brand it was.  I've never gotten a recall notice; I don't know if I have a recalled device or not.  I do know that my good knee has an implant from Zimmer, manufacturer of two of the recalled items; because in 2001 I asked, what product will you use?  I didn't ask in 2005.  Mistake.  I've asked my surgeon this time but he hasn't responded.  Yet.

I may be letting my anxiety get the better of me, but it's dawning on me that when I decided to have the original surgeries, I was signing up for an unknown number of repeat procedures, at unknown intervals, which are turning out to be much shorter than I expected (and hoped).  I thought I'd be able to walk without a cane again, and for about 4 years, I could.  I read some very scary stuff about revision surgery - and then I realized it was posted by the lawyers in the class action lawsuits related to the recalls.  Oh.  I found a description on a medical site that was much more balanced and less frightening.  But I'm still not happy.  Every surgery carries major risks.  But there really isn't a choice now - I can barely walk on that leg.  Wish me luck.

Friday, March 04, 2011

Literary Echos

I've taken to frequenting my local library, largely because I'm running out of space for new purchased books.  (Someday I must prune.  After the surgery.)  Since the library has a complete bound set of Agatha Christie, I've been going through the ones I didn't buy - I have a fairly complete set of Hercule Poirots, and a lot of Miss Marples, but I never bought Tommy and Tuppence, or the non series books she wrote.  So on my last pass I picked up The Man in the Brown Suit, and it gave me a revelation.

Let me digress - there is a reason for this.  Another favorite detective series of mine is Elizabeth Peters' Amelia Peabody books, the increasingly outrageous tales of archaeology and intrigue in Egypt, anytime between the late 1880s and World War I.  In the first book, Crocodile on the Sandbank, Amelia introduces herself as the practical and down-to-earth daughter of an unworldly scholar father, who leaves her to deal with "the butcher and the baker," and all the other details of daily life, while he writes arcane papers on Egyptology.  Eventually he dies (it takes his club 3 days to realize it) and leaves Amelia stinking rich, and off she goes on an adventure.  This book was published in 1975.  Amelia's description of her father and herself has always been one of my favorite sequences, and I've read the book at least a dozen times.

So I sat down with The Man in the Brown Suit, and read the chapter about the exotic Russian dancer in Paris; and suddenly the scene shifts to England, and I'm listening to the first-person narrative of a young woman named Anne Beddingfeld, the down-to-earth and practical daughter of an unworldly scholar father, who leaves her to deal with "the butcher and the baker..."  Does this sound familiar to you?  It stopped me in my tracks.  It made me laugh out loud.  I haven't compared the two books word for word, but the passages where Anne and Amelia introduce themselves and describe their fathers are so similar that I was floored.  The rest of The Man in the Brown Suit isn't at all like Crocodile on the Sandbank - for one thing, Anne's father leaves her flat broke, and she goes off to South Africa, not Egypt - but I feel I've met the spiritual ancestor of Amelia Peabody.  And she was created in 1924 by one of England's great crime writers.

The Man in the Brown Suit answered another question for me.  My crime library contains a 1936 hardback edition of Christie's Cards on the Table, which is basically a Hercule Poirot novel, in which a quartet of detectives (Poirot, Superintendent Battle, Ariadne Oliver, and a Colonel Race) are matched with a quartet of people who may or may not be murderers - who knows?  They all sit down to play bridge, and then the host is murdered.  Now, from my reading of Poirot novels, I was well acquainted with him, and Mrs. Oliver, and Superintendent Battle, they're all regulars - but where did this Colonel Race come from?  (Supposed to be something in the Secret Service, you know.)  Well, he came from The Man in the Brown Suit - he's a major character in it.  I'll have to see if I can find any more about him.