Thursday, August 27, 2015

Knee High

I'm two weeks past having my right knee replaced. Still somewhat stiff and swollen but I'm walking, going up and down the stairs fairly easily, and doing a lot of exercises twice daily to make the whole thing work in the end. It seems only slightly crazy that my "good" knee, i.e., the one which I plan to replace two months from now, feels better than good, now. 

The experience, on the whole, has been highly positive. The surgeon and the physical therapists have been great, as have been the home health nurse and the caretaker-in-chief, Eileen. Spending five days more in rehab was on the whole worth it for the more intensive physical therapy.

Either I could go right home and people would come to my house with therapy and home health care. Or I could go into what is called rehab for some days or weeks. Rehab sounded like a good choice. It meant I would be taken to physical therapy twice a day, and given some occupational therapy as well. The rehab unit--the physical therapy part, that is, and although less needed for my particular surgery, the occupational therapy--was excellent and stretched my capacities as those needed to be. 

Apart from the therapy, however, I was in a nursing home. And that's just what the contract for services that I signed said it was. Ostensibly they have tried to combine the two functions, but when you leave the therapy rooms, you are in a nursing home. This means reduced levels of service from what you expect in a hospital and a reduced level of competence in basic skills.

Things that I know all too much about, like legal liability and corporate structuring, help make this so. Example: if you are in one of these units, and it is attached to a hospital, it may not have access to the medical specialists that the hospital has available. It is a separate structure, designed to keep costs down.

Because you might fall, for liability reasons it struck me that no one encourages you to begin learning to get around without a walker. The five nights I spent in rehab were worthwhile because I began to get into the specific routine of focused exercises. This was highly desirable, since our house has lots of steps, with not all vital functions on the same floor.  This is also why I was eligible for rehab. But after five nights in this unit, I began to see that the experience wasn't desirable for me psychologically.

So, yes, all appears to be working out for the best. This is also an experience that draws on what might not be my most outstanding virtue: patience. Yes, for this procedure to work, doing the exercises is critical, but results are cumulative and I have to keep reminding myself of that.

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