Sunday, July 11, 2010

With A Little Help From My Friends

I'm sitting at home this July and really, really at home for a change. I built my home to provide shelter for me from the sun and wind, to be a place to sleep in, and to be small and easy to care for. I have two small steps that go from the house to the garden, installed with the thinking that as I get older, the last thing I want is to have to deal with a bunch of stairs. There are no steps inside the house and everything inside is within easy hobbling distance. All of this is really useful right now because I had a bilateral knee replacement last week and I am not allowed to even tackle the little stairs to the garden until my staples come out.
The decision to do a knee replacement was a difficult one. On one hand, I began suffering serious pain in my knees last fall and walking was becoming torture. If walking on the smooth sidewalks of New York in June was bad, one can just imagine what it was like on the uneven ground of my farm. And if I couldn't walk comfortably to see my horses and to move around....what was the point of having legs anyway? Oddly enough, riding was the one thing that I could do for hours without any pain at all...but you can't live on a horse, no matter how much it might seem like a good idea.

I started doing research on knee replacement, talking to friends and family who have had it done. My younger brother had his done, which made me suspect that part of the problem was genetic, a malformation of the knees that my doctor had noticed when he looked at my xrays last fall. He said that I needed to do them both but we could either do them one at a time or at the same time. The real issue for doing two at once was aftercare. Friends here asked in astonishment "You are going to do a surgery like this in Egypt?" But the surgery itself wasn't nearly the concern that managing for the first two weeks after surgery was. We have some very good hospitals here and excellent doctors, though our nursing leaves me homesick for Canada. But on the other hand, the hospitals are set up here with the understanding that you will have a friend or family member staying with you to assist you. I decided that a lot of pain once was better than a lot of pain twice and opted for the bilateral surgery.

The surgery itself was in a relatively new hospital in Medinat Nasr with a very nicely equipped operating theatre. I was having an epidural with some interesting goofy juice to keep me out of the doctors' way. It was a long surgery, about 6 hours or so, and I recall coming to some incomplete consciousness (no pain...and I wouldn't swear about the consciousness) to be aware of the sounds of hammers, drills, and other power tools. I exited the semi-consciousness as quickly as possible as power tools should never be associated with someone's body....EVER. The first few days after surgery are best not remembered much....catheters, drains, yuck. But they were fine with the pain meds and we coped ok. The day after the surgery, I was given a walker to practice standing up and walking a bit, but it was the much anticipated removal of the tubes that provided the stimulus to get up and walk to the bathroom. Little triumphs, like washing my hair over the sink in the bathroom so that at least part of my body felt fresh, made huge differences to me. I was in the hospital for 5 days including the day of surgery and friends stayed with me in shifts for the time.

Finally I was sprung to go home to my vast relief...and the relief of my staff and friend Kelly who came here for a holiday and found herself dogsitting. The staff shut the dogs into the back garden while I arrived so that I could maneuver myself into a chair in peace, then we barricaded my knees with the walker and loosed the hounds. A walker is a terrific fence. After about 5 minutes of insanity on the part of the dog pack, they settled down to the reality that I was really back and not going anywhere soon. They'd never seen a walker before but very quickly learned to get out of the way as I was hobbling around the house. We'd made some helpful adjustments to the house, like adding a twin mattress on top of my king-sized mattress so that my bed was at an easier height for me to get in and out by myself, and getting a toilet seat extender to put on top of the toilet for the same reason. When your legs are functioning in a pretty funky manner, you really appreciate having a tall toilet and bed. Another friend had donated an old lazyboy chair to the living room and that has really been a lifesaver as I can adjust my body to stay comfortable.

The first "setback" was actually a very useful lesson for me. After I'd been home about 24 hours and the residual pain meds from the hospital had worn off, I had a really tough early morning with muscle cramps running up and down my right leg. I was in tears and called Kelly in the guesthouse. A friend of mine who is a massage therapist was staying there for my first week home, and she came over and massaged the muscles in my leg until I could relax enough to sleep again. The lesson learned was that while the orthopods can give you pretty shiny new knees to work with, it's your old muscles who are going to be doing the work, and probably not without complaint at first. While I expected pain from the surgery site, I was unprepared for the muscle cramps. Magnesium supplements, massage, and a mild anti-inflammtory took care of that issue and I was humbled before my 60 yr old muscles.

Now I have about 3 days before the staples come out of my knees and I will be given the go ahead to hobble around my garden where I should be hobbling and to begin my serious physiotherapy. The movement in the new knees is a wonder to me. After what I realise has been very long time of pain and discomfort, these new bionic knees slide so smoothly with my leg movement that I am in awe and remember the joy of free movement again. I've been resting a lot between wanders around my tiny body is quite happy to tell me to remember my age and not push things too hard. Pushing things too hard is part of what got me here in the first place.

Would I do the surgery here again? In a heartbeat. My doctor did a beautiful job on the surgery and my friends have been so amazingly supportive of me, popping by with gazpacho soup, fruit cake and fresh cherries and helping with the few summer clients that come by, my staff have been there to handle all my responsibilities, and the core group of nurses (the two Mona's, Kelly and Sabine) who have been so very helpful in my post-operative care. I am amazed at the love and care that have surrounded me. I went in to fix my knees, but came out with a new appreciation for my life.

copyright 2010 Maryanne Stroud Gabbani