YES, I can!

It has been a joyful 24 hours. My youngest daughter phoned last night to share that she has gotten engaged to be married. We are very excited for her and wish her all the best. She and her guy have been together a while and have decided to tie the knot.
Today at physical therapy I was able to pedal the stationary bike all the way around! This is truly exciting because I am 15 days post total right knee replacement. I do not imply that it was fun, or easy, I merely state that I previously had not been able to do it and now I can. I am very excited. I am also exhausted. I didn't realize that pedaling slowly for 5 minutes with no resistance could make one so tired. It will get easier, It will get easier, It will get easier, It will get easier, It will get easier, It will get easier, It will get easier.

Life continues. . .

Yesterday, I went to the office for the first time since my surgery and enjoyed visiting with everyone. I got very tired and came home and took a nap. I was saddened because just as I arrived they had confirmed a term fetal demise in one of our patients so my midwife partner was busy with that, and we didn't get a chance to visit. I just gave her a hug and told her I was sorry. She went to the hospital with the patient to labor sit and ultimately deliver this stillborn baby. She called later in the day to say that it was all over, but she was really sad. There is nothing I can say or do, I can just reassure her that I know it is hard.

On a more positive note, I get to go visit my grandchildren on the East coast during my convalescence. We got our tickets and I am so excited. It will be great to be with them, and it is spring break, so the older kids will be out of school. My granddaughter told me on the phone the other day "We will go to the National Zoo. We will take the Metro because it is very exciting. We will walk and walk and see all of the animals when you are here." I told her that sounded wonderful but that we would have to wait and see. I will be 6 weeks post op when we fly out. I am not sure about my strength or mobility. Speaking of which, I am using a bike to increase my flexion and extension, it is fairly painful, but everything I have read assures me that this is just stretching the muscles. I cannot make the pedals go all the way around yet but I get closer each time I work at it. I try for four separate "practices" everyday. I think it is working. Today, I was able to go down the stairs alternating feet, which I have not been able to do in years. That is definite progress and for that I am pleased and excited.

Baby steps

I am post op day 12 today. I can now walk without a limp (when not too tired); climb stairs alternating feet not using crutches or aides (can't go down without assistance yet); I have 85 degrees of flexion and almost complete extension. The residual rash from the anesthesia reaction is almost completely gone. I am feeling better each day. I am trying to work hard at my physical therapy but sometimes it is hard as it hurts. Now, intellectually, I realize that I have to work to stretch out the muscles and regain years of lost flexion and extension; however, emotionally I keep asking myself why I am causing myself pain. I have no good answer. Tomorrow I will go to a carry in lunch at the office after my physical therapy. Then of course it will be home for a nap, but then what can one expect.

Life's little inconveniences

Today I am post op day 8 from a total knee replacement. The first week sucks. I'm told the second week also sucks. By the third week, things are supposed to be looking up and getting much better.

I'm officially off work for 12 weeks and my hospital requires that I take a medical leave of absence, giving up my clinical privileges until my surgeon releases me back to work insuring that I will not be a hazard to my clients thru impairment because of drugs or pain. What a bureaucratic mess. Like I didn't have pain on a daily basis prior to the surgery (duh).

The surgery itself went well and I came thru that without a hitch. The recovery has been interesting. I had a severe allergic reaction to the narcotics that were used to control pain (there was very little, so they probably worked well) but I broke out all over my body with a blistery rash and it felt like fire ants were constantly biting me (my skin burned and itched fiercely). Oh boy, that was fun (not). I took Benadryl for the itching which made me comatose. I came home on post op day 3 (Superbowl Sunday). I live in a two story home that you have to go up a flight of stairs from the garage to get to the first floor or up an outside stair-filled walkway to the front door, so just getting in was a big deal. Of course, I was up to the challenge (there was no other way) and got home and got settled in the loft where I slept the rest of the day away. I started physical therapy Monday. Tuesday I had a melt down and cried multiple times. Wednesday I had physical therapy and the rash started to abate, I began to feel much better. Wednesday night I got my foot caught in the covers and wrenched my knee jerking awake with agony and terror. Thursday, I was tearful but did OK. Friday, I went shopping for a new refrigerator and then to physical therapy. Now why would someone 7 days post op from knee replacement surgery go shopping for a refrigerator you might ask - I know I ask myself what I was doing. The answer is that the refrigerator at the house has been broken for 3 weeks and the repair guy came Friday morning and let us know that basically the cost for repair was $800-900 and perhaps we would like to consider a new fridge. This became ever more necessary when the repair guy told us that the new compressor would be delivered FOB, take 2-3 weeks to arrive and cost another $200-300 shipping and installation. So that is how I ended up shopping for a new fridge 7 days post op.

One of the biggest challenges is that I don’t' have a good mental image of how the rehabilitation will go. I'm a true believer in the adage "I create the dream, I make it happen." However, my dream for the rehabilitation is really, really fuzzy and this is causing some problems (crying and carrying on). I keep working on the patient, persistent, strengthening vision, but it is really weak. I see hiking, biking, traveling, and working (end view) with vague pictures of baby steps learning to walk. I'll keep working on the vision day by day.

So now it is just a regimen of exercises and strengthening so that I can get back to the birthing barn and catch those babies. Right now my partner has control of the practice and is doing all the births. I bet she is tired. I know I was before she came to be part of the group. I'm starting to miss it, though.

SNOW

This weekend I was off call and I had an appointment in the city with the physician who is going to do my knee replacement. After that appointment we drove to spend the weekend with our daughter. We had a delightful dinner with them and visited for a while (it was raining), then went to bed (it was raining). We woke (it was raining) and cooked the cinnamon rolls we made last night had tea and generally enjoyed not rushing (it was raining). In the late morning we gathered ourselves and went on an adventure to the IKEA store (it was raining). When we arrived back at our daughter's house it was still raining and the prediction was for freezing rain and snow. We talked it over and decided that the best course of action was to cut our visit short and get home. It rained the entire trip home, but as we headed south, the temperature got warmer it was 34 degrees when we left our daughter's home and an hour or so south it was 41 degrees, we breathed a deep sigh of relief and kept driving to get home safely about 10:30 (it was raining) where we spent some time unwinding and then off to bed (it was raining). Wow! We woke to snow and snow and snow. I just talked to my midwife partner (who is at the hospital) and she said that the OR crew has been called in to just hang out and that ambulances are not doing transports because of the weather. She has been really busy this weekend. I told her that I'm not sure that I will be in tomorrow, because I don't know if I'll be able to make it down the hill. I live in the mountains above the town where I work, and there may not be a safe way into town. Oh darn - a real snow day!

Still catching up with EMR

All the ultrasound data for December is now entered. I added up the number of births that I did this year and it was 190 down from my high of 334 (2004) and up from my low of 138 (2001). Now all I have to do is get all the OB visits entered into the EMR prior to 1/2/08 when the office re-opens. My partner is on call these days, but I delivered almost everyone, so her days will probably be easy. I hope so. We are facing a big new year. I will be off for quite a while (12 weeks) due to knee replacement and she will be doing it all. I hope there is a practice for me to come back to when I'm healed from my knee. I keep seeing many requests for (partner's name) for care and delivery in the charts. If I'm not there working perhaps no one will want me to do their delivery.

EMR "electronic medical records"

Ah yes, the practice I am associated with has made the big transition to EMR's. Most of the time having the chart absolutely available all the time is wonderful. I am never searching for a paper chart. I am never looking for stuff that hasn't been filed properly. I am never looking for paper that hasn't been filed yet. HOWEVER, the 1 tenth of a percent when there is a server failure, I am left with nothing. That is not even a hint of what has gone on in the past. I don't know what labs have been drawn (of course they come electronically). I don't know the estimated date of delivery. I don't know any of the psycho-social history. I don't know anything that I can't remember on my own. Now you may be getting a hint of the fact that there has been a server failure in my practice and you would be so right. When this happens you scribble notes to yourself on little pieces of paper and put those pieces of paper into folders to be addressed later (when the server has been repaired). This doesn't sound bad, except that this went on for most of December, off and on so now that I have a few days where I am not at the birthing barn, I'm tied to the computer trying to get my nose above the surface so that I will be able to function in the new year. YUCK. I do love electronic records when they work well, but when they don't work it makes life absolutely awful.