Diary of a Total Knee Replacement V

Ahh Food!
one of the best things about a Knee Replacement! Friends and family are kind and generous enough to bring you meals as you recover.

Just when The Husband and I thought we might start clucking at one another like chickens, a dear friend dropped this dish off for dinner. Our mouths watered for days afterward. She combined it with lightly steamed broccoli and not one, but two desserts: A Lemonade Ice Box Pie and a Chocolate Cake iced with Chocolate Ganache. When I called her afterward for the main dish recipe, she told me that it was Pioneer Woman's Shrimp Scampi. Pioneer Woman labels it an easy 16-minute meal! Wow! The recipe is getting even better! The link for this dish is below.

Pioneer Woman's Shrimp Scampi.
Divine. Need I say more.

You can find the recipe for this easy to prepare dish at the Pioneer Woman's website:
http://thepioneerwoman.com/cooking/2011/04/16-minute-meal-shrimp-scampi/

The Lemonade Ice Box Pie this same friend brought was light and delicious! You won't believe how easy this recipe is!

Photo courtesy of allrecipe.com

Lemonade Ice Box Pie
1 Honey Maid Graham Cracker Crust
1/2 cup of cold water
1/3 cup Country Time Lemonade Drink Mix
2 cups of softened vanilla ice cream (My friend used Edy's)
1 8 ounce tub of Cool Cool Whip, thawed

Dissolve the 1/3 cup of Country Time Lemonade Drink Mix in the 1/2 cup of cold water. Pour into a large bowl. Add the two cups of softened vanilla ice cream. Stir together well. Fold the whipped topping into the mixture and spoon this into the Honey Maid Graham Cracker Crust. Freeze for about 4 hours for a ready-to-serve delicious pie. If you like a creamier pie, let sit out of the freezer a few minutes before slicing.

I really like this pie. Nothing fancy, but flavorful and easy to make. All I can say is that this pie did not last long around our house.

Some of our other dinner-time favorites have included:
Marinated Grilled Pork Tenderloin
  This was delivered the day we came home from the hospital with a package of frozen ready to cook biscuits. The Husband pulled some sides together for a perfect and easy supper and then we ate it throughout the week sliced thin on sandwiches.
Homemade Tomato Tart
   A quiche-like dish with a melt-in-your-mouth crust and lots of gooey cheese, topped with Roma tomatoes, served alongside steamed asparagus and focacia bread. This was a nice vegetable meal that combined lots of color and taste.
Homemade Chicken Pot Pie
   Chock full of vegetables and chopped chicken in a sherry based sauce, this was a pleaser as one of our adult children who was at the house decided he just had to eat with us, as well. It was not only filling and very satisfying, but it heated up well the next day for a leftover lunch.
Jambalaya
   You should probably check to make sure about the level of spice that the patient enjoys, but the nice thing about this easy dish is that it can be either hot or mild. One friend who brought it to me makes it with Zataran's Brown Rice recipe to which she adds sausage, peppers, onions, and leftover chicken or barbecue. Sometimes people hesitate to bring a spicy dish, but I always look forward to something that will jolt my palate.
Macaroni and Cheese Main Dish
  This is totally Southern comfort food to me. I really don't need much else except a green vegetable, and I am happy camper. The Daughter and I bought some gourmet frozen macaroni at the East Nashville Farmer's Market a few days before my surgery. I stuck it in the freezer for a weekend night. It was perfect.
Spaghetti
   In my book spaghetti constitutes another comfort food. The friend who brought it this time is a bit of a gourmand so her spaghetti is not just standard fare. While it is packed with fresh vegetables, her spaghetti's distinctive flavor comes from the use of sausage rather than the more traditional ground beef. Ummm delicious.

This is the second time that I have been the beneficiary of a Care Calendar, and it has been wonderful! I highly recommend it. Once you get over the initial embarrassment that you even need a Care Calendar, relax, sit back, and enjoy the experience. There is no pressure for your friends: they simply look over the list of needs on the specific dates and then decide for themselves whether or not they can participate!

Finally, here are a couple of additional things I learned from my Care Calendar experience that might be helpful for others.
 1. Label your food clearly. Not just the temperature to reheat or cook, but what the dish is and the ingredients used. It is also helpful to know whether the dish can be frozen or refrozen.The Husband and I ate something that while delicious, remains a mystery to this day!
2. Do what I call "The Stop and Drop" when delivering food. Just park your car and leave it running. Despite what anybody says to the contrary, run the dish inside, give the instructions to the family member or leave your food on the kitchen counter. On your way out wave hello to the patient and make a quick exit. I totally appreciated the folks who understood how important it is not to linger.  People who have undergone major surgery are often in a fog or might not be dressed to receive visitors!

Diary of a Knee Replacement Part IV

Let Me Introduce You
   1. TED Hose -- if you have any kind of joint surgery, you will make TED'S acquaintance. TED's are the thigh-high compression stockings that you are issued when you leave the hospital. All SJRI patients are required to wear them during the day for 6 weeks. While I view TED's presence as a relatively minor inconvenience in the whole scheme of things, I have some friends at PT who are not so nice about TED. They hate him. And I mean hate him. I don't mind TED hanging around because I think he really helps me with the swelling, edema, and pain, so he has earned his chops in my book. I do, however, agree that TED totally wrecks your fashion aesthetic, but since my social life is largely confined to visiting with friends at the Southern Joint Replacement Institute's Physical Therapy gym, I don't feel too out of place sporting my bright white TED's.

This picture made me laugh. It's like they are trying to make these
things look sexy or seductive. Trust me, there is nothing
sexy or seductive about TED hose, especially when
they get loose in the top and like to jelly roll down your legs.

   2. The Knee Immobilizer -- while you met the knee immobilizer briefly when I was in the hospital, this chick's role expands exponentially when you get home. You are required to be strapped into this lovely strait jacket for legs for 8-10 hours per day. Miss Knee Immobilizer and I hang tight at night. I couldn't abide her presence during the day, but I guess it's feasible that you could get your hours in if you were persistent with it. She's not so bad as the monster I am getting ready to introduce, but she is definitely not a friend for life, if you know what I mean.

Mine is black and looks great with the thigh high white TED Hose.
 It's a true fashion statement.

3. The Monster Man -- PAIN
  This is the one guy we all want to avoid at any cost, but let's just face it, from the minute your surgeon makes his first cut with that scalpel, this guy has your number. He's a stalker. And he loves to do his dirty work at night. While Monster Man begins to invade your boundaries in the hospital as the nerve blocks begin wearing off, he usually waits to completely ambush you until you get home.
   You are confident when you leave the hospital. Thankfully, the doctors at SJRI are firing some pretty big cannons in their arsenal against this guy, and they want you to take advantage of what they are giving you. In other words: TAKE YOUR PAIN PILLS. Everybody from the Discharge Nurse to the Case Worker to the Hospitalist to your Surgeon to the Physical Therapist -- are all saying the same thing, "Take your pain meds. Do not let the pain get ahead of you. Take them every day and take them regularly."
   The only problem with this strategy is that once you read the label, you are not entirely happy with this advice. Deep down you are worried about the pain meds. The long and the short of it is that they are ADDICTIVE. And you know it. In fact, everybody knows it. But here you are...going home with a 90 pill supply of these boogers. You find yourself hoping, "Maybe that's one a day for the next 90 days." NOT. You are also encouraged by the in-the-know medical personnel not to try to be the hero. And you are thinking to yourself, "Yeah, right...you just don't know me."
     My hip replacement did not kick my butt in terms of pain, but my knee replacement sure has. I thought my pain tolerance was pretty high, and it is, but this pain is on a whole other level. And I have even had natural childbirth, the standard by which every woman measures another person's ability to withstand pain. I did well for a couple of days, and then this searing, burning, clawing, pressurizing pain started camping out at my door. The Monster Man would remain dormant as long as I was completely inert, but if I moved around or heaven forbid, stood up, it was right there in my face breathing its hairy fire-breathing breath all over me. Sometimes I wanted to vomit. Sometimes I wanted to scream. And sometimes I wanted to quit. It was bad.

     I threw everything in the book at this particular Monster Man, but he was not giving an inch. I followed the Doctor's orders. I pushed the envelope to its limit and took the maximum daily allowance. The Monster did not leave. I keep a diary/log of all medications I take because who can remember at 2 am when you last took something. I look back at the journal now and can track the steady progression of this pain. It was building and building and building until it was a consuming fire, burning a hole in my leg from the inside out. Talk to five different knee replacement people and you will find five different stories about the pain. Some are more fortunate than I was. Some suffered more than I did.
   But the story isn't over yet. Every day when I walk into therapy (and you go five times at SJRI the first week) the cheerful therapist, in this case Che Che, asks you to rate your pain. Mine was usually in the 3-5 range until this Monster Man showed up and then I jumped to 8-9. A few times I even hit 10. That's usually where you hear the wailing and gnashing of teeth. The good thing is that my therapist listened to me. I mean she really listened to me. She helped me determine that my pain sounded more like nerve pain with its burning, clawing and licking fingers of fire. So I marched (that is a total lie since I could not have marched anywhere even if I wanted to), okay I slid my walker in front of me and dragged my knee behind it down to the nurse's station where I talked to my Surgeon's Assistant (Sweet Lindsay). I told her what was going on, she took one long look at my face and she said, "No problem, we will get you a prescription for some Lyrica."
    Lyrica. Sounds like music to my ears. And music it is. Lyrica has proven to be my new best friend. Within three hours of the first round of Lyrica, I had a 30 to 40% reduction in pain. I went from an 8-9 on the charts to a 3-4.5. It went from unbearable to bearable. I went from being a monster myself to being a relatively nice human being.
   At this point in time, I have weaned myself off of the heavy duty pain meds because they simply don't seem to work well on my pain. I was having to take so much that they were leaving me with cotton on the brain instead of normal brain cells...and I was still hurting a lot. Lyrica is not a walk-in-the-park drug, but it works for me and is one, that hopefully, I will not be tethered to for long.
   All of the knee replacements talk seriously about our pain. We joke about the TED hose, the Immobilizer, the Walker and the other accouterments, but we don't really joke about our pain. We know the Monster Man in this case is all too real. Hopefully manageable. Hopefully not with you forever. But real enough to take him seriously.
   I would that hope some Physical Therapist, or Nurse, or Doctor, or Patient Advocate somewhere is reading this and thinking, "I really need to let my patient talk to me about her pain," or "I need to pay more attention and consider other available options."
   I sure hope so because there is more than one answer to the problem of pain. The Monster Man can be defeated or at least tamed. I am proof of that.

Diary of a Knee Replacement Part III

The Hospital Day Two
   The morning dawns bright and early. I am already on a first name basis with my night shift nurses. I should be. They were in my room and in my face every two hours during the night. And that is not counting the visit from the night vampire: the tech who draws the blood. I know that there is going to be a shift change at 7, and the new crew is going to stop by to make my acquaintance. I want to get on good terms with them because I need to get my catheter removed first thing. FIRST THING cause this darn thing is driving me crazy. I already feel better today after being fortified by my dinner last night of chicken broth and orange jello. I am ready to face the world. But I have to get this catheter OUT.
   I call ahead to the "Room Service" to order my customized breakfast: grits, bacon, coffee (yes!), and fresh fruit. I am not a big breakfast eater, but I know that I need to eat.
   It's not rocket science to know that I am having a terrible hair day and my mouth feels like it needs a good scrub. Every woman knows that the finer details of one's toilette must always be perfected in front of a mirror. A bed does not suffice. I also want to get out of my gown and into the lovely outfit that Southern Joint provides (not free of charge, I am certain) for you: a navy t-shirt with the Southern Joint logo and a pair of gray gym shorts. Yippee. I also know that I will have Physical Therapy not once, but twice today. I am so excited. Not.
   The young nurse assigned to me senses my desperation and tells me that I will get my catheter removed shortly. I hope her idea of shortly matches mine. She reminds me that I may NOT get up without assistance. I nod as if I comprehend.
    I try unlooping my catheter bag, but I am not having a lot of luck with it. And then there's the IV pump on the other side of the bed. I determine that I really am going to ask for help if I want to get up.
    She comes back. Yay! On her command I take a deep breath and whoopee, I am a free woman. I am no longer tethered to the catheter! I know I need to wait a bit to get up. I want to consolidate my bathroom trips to keep my time on my feet to the limits they have imposed. In the meantime, the tech helps me get dressed in my "uniform." I am already feeling a little more human and that's a good thing.
   PT comes in and this time, I try not to pass out (as if I tried before). We make it all the way down to the nurses station where I wave to everyone. I feel sorry for my therapists. I have still not brushed my hair or my teeth. They are courageous men and women in my book. We head back to my room and I ask them to drop me off at the bathroom. They comply and tell me that I must use the call button if I run into trouble. I find what I need in the bathroom and give myself a quick make-over. In the hospital a make-over is brushing your hair and scrubbing your face and teeth. I even slather some of their all purpose cream on my face because my good stuff is in the bag beside my bed. Oh well.
    The day passes quickly. I have a few visitors, lots of check-ins with the nursing staff and another round of PT. My extension and flexion amaze me. When Dr. Hodrick stops by I brag on myself. I know that he is thinking something that I can't quite grasp. Then I remember that the nerve block is still working. He reassures me that he was able to get great flexion and extension in the operating room so I should be in good shape as I move forward with my therapy. Yikes. My Hospitalist comes in later and spends some time talking with me about pain management because I am going home tomorrow. She goes over the meds that have been prescribed and what I can expect. I am still not hurting much, if any, at this point, so I am hoping her comments are superfluous.
    Sometime during the night my block starts to wear off, and I have this dull ache and slight burning pain thing going in my leg. It won't go away. I start to worry how I am going to manage without my lovely pain medication. I am now having to ask for the pain meds. A couple of times during the night I am actually counting down the minutes until I can have my meds again. I am thinking that this does not bode well for the future.

Day Three and Heading Home
   Even though I have brought my own pillow to the hospital, I am ready to sleep in my own bed. I know that I will be more comfortable. I am tired of making friends with the night shift. As a Southern woman raised right, I make it a point to be as nice as possible to everyone who enters my room, even if it's two a.m. in the morning. I know about everybody's children and grandchildren and why they wear each of the pins on their badges. It's a lot to keep in my fuzzy head. At this point all I want is sleep, uninterrupted sleep. And I know that even though I will have PT twice today before I go home, I will have a break on Sunday. I can't wait.
    My gourmet breakfast of oatmeal, fruit and two cups of coffee (ahhh) arrives at 7:30, and the day nurse gives me her low-down on the best items on the menu. On her recommendation, I am going to have the chicken quesadillas for lunch. I wonder where she was yesterday when I was playing Russian Roulette with the menu. I ask her if she will help me get up to take a SHOWER. I am going to be a real person again. I will be clean. No more hospital smell. I have even brought my own soap, my own shampoo, and my own lotion. I forgot to bring my own towel, but I get the tech to bring me four or five of the hand towels that are supposed to double as body towels. The nurse agrees that I am ambulatory and off I go.
   As soon as I got into the shower, I knew that I did not want to get out. The water pressure was great and the temperature was hot. If I closed my eyes, I could easily forget my surroundings and the fact that I was seated on a shower chair in a room with a drain in the floor and a two call buttons on the wall. I stayed in there until my hands were good and shriveled. It felt so good.
   I put my uniform back on and decided to take a good nap. My PT session in the afternoon included a training session on how to get in and out of the fake car that they have in the little gym. Of course I tried to get into the driver's seat, but they reminded me that I will be the passenger for six weeks. I don't know whether I will survive. We also practiced going up and down steps on their little staircase. I passed all of their tests and was deemed capable of being released from the hospital.

See the stairs to the left and yes, that's the fake car
where we practice getting in and out of the passenger side.

     Now is where the itchy pants come in. I have cleaned up my room, gathered up all of my possessions and am roaring and ready to go. No husband in sight. As the last man standing in corporate America without a cell phone, there are times when I am ready to ring The Husband's neck. He is nowhere to be found. Just as usual, he is off the grid. I am fussing and fuming. I think about calling the grocery store and having him paged but I have been there and done that too many times already. I also discard the notion of calling our local Y to see if he could possibly be there. I go over my discharge papers with the nurses and think about hitching a ride down to the patient pick up area, but then I realize that he will not know to look for me there. I call my children to complain. This eats up 30 minutes. I have four children. Just about the time I am ready to pull out my hair, The Husband breezes into the room all happy and cheery. My chicken quesadillas look so good (my leftover lunch was still there) that he wants to finish them first. He is definitely not in a hurry. He does not understand that I am propelled by visions of the comfort of my own bed in my own house.
   We get moving. I have not seen the sun for three days. It feels wonderful. I make it up the steps to our house and down the hallway to our bed. I fall into its comfort. I am home. I have a new knee. I don't have PT again until Monday. God's in His heaven and all's right with the world.

Recovery From A Total Knee Replacement Part Two

The Hospital Day One
  Waking up in the hospital. There's nothing wonderful or exciting about waking up in the hospital except the fact that you actually do wake up. The alternative is something I don't want to talk about just now other than to say that if I had not waked up in the hospital I know without a shadow of a doubt that I would be waking up instead to the glories of Heaven. Either one is great in my book. Here or There. Sometimes There looks a lot better than here. But I digress.
   Betcha you didn't know that just waking up from anesthesia is hard work. I vaguely remember someone hollering my name and telling me over and over to open my eyes when all I want to do is go off and have a nice little nap. But no. You have to wake up. They don't really give you another option.
    The next thing I remember is that I am in my room. And the comforting presence of The Husband is there. He pats my hand and tells me that everything went well. I look around. I have a drain in my knee, I am connected to an IV pump, there's an oxygen tube in my nose, and a lovely see-through catheter bag looped over the end of my bed. Finally there is a blood pressure cuff that looks like it's not going anywhere around my arm. I couldn't escape if I wanted to. The good news is that I feel NO PAIN. So I don't need to escape. Not yet, anyway. Okay maybe I am feeling a twinge of discomfort, but no real pain. They use these rating systems for pain now in the hospitals. It must be some universal protocol. They even gave me a sheet with little faces corresponding to the numbers on the pain chart. I guess you can always make the face if you are unable to talk. In the last two hours, they have asked me five times about my pain level. The nurses are hovering at this point. And they tell me that I can have some wonderful delicious ice chips to eat. My mouth feels like a really really bad hangover so I am excited to have ice chips, and since it feels like a hangover, I know that I do not want to eat...yet. By the way, I don't think my Momma knows that I know what a hangover is despite the fact that I am nearly 60 years old.
   But wait, I have this headache. I have not had any caffeine for like 24 hours. I know that I am going to develop a migraine. I tell the nurse expecting them to just pat my hand because a headache is relatively minor compared to everything else that is going on with my body, but no, she takes me seriously and puts something in my IV for my headache. Maybe it was liquid caffeine. I don't know but I start to feel pretty good.
   Some of my family comes to visit and then the doctor stops by. I ask about the femoral nerve block and he tells me that I got two blocks, so as far as the pain goes, I should be in pretty good shape...until it wears off, that is. He says the replacement went well and I ask him about my knee. He tells me that the knee was terrible and horrible. I immediately think about the children's classic, Alexander and The Terrible, Horrible, Very Bad Day. My knee has had its last Terrible, Horrible, Very Bad Day. I am thankful. The new knee has a good future. Maybe I should sing, "Happy Days are Here Again..."
   We discuss that I will have physical therapy later that day, and that I will likely go home on Saturday afternoon. Today is Thursday. I dread the physical therapy. I look at all of the tubes and think about walking around and I don't feel very excited. But Dr. Hodrick is very reassuring.
  Sure enough the PT folks - all three of them - come into the room late-afternoon. I think I am their last patient of the day. I am hoping that I will not be a doozy. We go through the exercises that I am supposed to be doing on my own in the bed: ankle pumps and butt squeezes. Exciting, huh. Then we do a few slides, and I actually get to see the dressing surrounding my knee along with my little drain. Then they tell me that they are going to get me up. That's why there are three of them. They drag out this knee immobilizer, strap me in and then get out this giant belt and tie it around my waist. It reminds me of something that has to do with a strait jacket. Mind you I have never seen a strait jacket and am not sure that they really use them anymore, but this belt reminds me of one.

This is the belt. See what I mean? They can tie you up good with this thing.

This is not a picture of my knee. I wish it were. But this is a picture of one
 of my favorite devices (not)..the knee mobilizer. I will be sleeping in this monster for six weeks. 

   I take a deep breath and up we go. Then I get cold. The room starts to spin and they are talking to me and saying open your eyes and look at us. I think I am back in the recovery room. They sit me back down on the bed. I get a break. Maybe we are not going to have to walk. But no, the belt is still around my waist. After I am fortified with delicious ice chips and some deep chest breathing, up we go again. I think I am doing well. One foot is going in front of the other, and I am using the walker to stabilize myself. Never mind that there is a therapist on either side and one in front of me. We start toward the nurses station. I am halfway there and all of a sudden I can feel my legs giving out. "Wake up, wake up, look at us." Who is hollering? They need to talk quietly. We are in the hallways of a hospital, after all. I come back to reality. I am standing upright. There are two people wedged up next to me and a third standing in front of me. We look like we are having an intense conversation. I finally put one foot in front of the other and make it back to the room. I think that they are all ready to go home for the day. I would agree. I am ready for them to leave. I make vague promises about doing my bed exercises and close my eyes. I am exhausted.
   The Husband sticks around until dark and then heads out. I am not my usual brilliant conversationalist at this point. I have actually resorted to grunting in response to his questions. He leaves. I go to sleep. It is the end of Day One.

Diary of a Total Knee Replacement (TKR)

Diary of A Total Knee Replacement (TKR)

Prelude
   I swear that I took my first step down this road when I was 13 and my knee dislocated in gym class. I was the new girl in school (I had been there one whole week), and the last thing I wanted to do was to draw attention to myself. No such luck. And then to complete the saga of ignominy, I had to wear this hideous total leg cast for 8 weeks. That's when I earned the beloved nickname, "The Stork."

  In the ensuing years, I have continued to struggle with the knee. Two laparoscopic surgeries later along with 7 rounds of Sinvisc, Supartz (you know the fake lubricant stuff that they inject into women's faces to even out the creases) and far more than my share of Cortisone shots, I knew that I was getting close to the end of the road. So I should not have been surprised when after the last round of injections, I broke down and cried like a baby. And I am not a crier. At least when it comes to physical pain. I pretty much endure. But I had hit the wall. When my doctor learned about my breakdown, he said that he was surprised I had made it the two additional years.
   So, we scheduled the TKR. In the practice where I go, there is a highly developed protocol that must be followed. Southern Joint Replacement Institute is ranked fourth in the United States with joint replacements (this is based on success, not on numbers of surgeries) and number one in Tennessee. I know that I am in good hands with these guys. And I also like my doctor, Jeffrey Hodrick. He's the one who did my hip. He is young and smart and personable and cute. That helps.
   So as I meet with the scheduling nurse, she gives my SJRI Knee Notebook, my pages of instructions and my appointments, which she schedules while I am there. I will have a pre-op evaluation with a Physical Therapist, a blood draw from the lab, an EKG, and a total health work-up with a Hospitalist (an Internist who is affiliated with a hospital and sees patients in the hospital for the doctor). I am also supposed to attend a Joint Class but I get an exemption since I have had a joint replacement within the past three years. The Joint Class is good. You are required to bring the person who will be assisting you with your care, and they spend a lot of time going over what you and your helper can expect following surgery. It's a lot of information, but is well presented and thorough. You also have an opportunity to talk one-on-one with a nurse from the hospital as well as a physical therapist.
   Instead of going to the class, I decided to be a good girl and read my notebook from cover to cover. I am not kidding here. I wanted to know exactly what to expect because after all, knees and hips are different parts of the body.
   In the days before surgery, I begin rounding up the necessary equipment I will need: a walker, a cane, and a shower chair. I also take up the bathroom rugs and go around the house and put all the scatter rugs out of the way. I also clean off my bedside table. Ugh. And then I try to make my bedroom presentable. However, I mostly put the clutter in the closet!
    My daughter sets up a Care Calendar (www.carecalendar.org) for me to arrange for meals three times per week along with rides to my thrice weekly physical therapy appointments. It's a huge help since I won't be able to drive for six weeks.
   I decide to do my PT with the folks at Southern Joint. When I went through my PT with my hip at Southern Joint, I watched the progress of the folks who were recovering from knee replacements. I don't know how to describe the particulars of their protocol, but all I can tell you is that it works. They even have a ton of people who drive 80 to 100 miles each way to do their therapy there. And then there are the unfortunate people who come because they are not making sufficient progress with the PT they have chosen and have to come to SJRI to "undo" what has been done. Ouch.
  So it's a no-brainer for me. I also like the fact that my doctor is right down the hallway and if something comes up, he and his nurses are available. So if it sounds like I am selling Southern Joint Replacement Institute, you are right, I am!

The Night Before
   I always go light on the last meal before surgery. I don't want to take my chances with post-surgery nausea. I have my bottle of Steris and I carefully follow the instructions about bathing with this stuff. I do it that night and then I do it again the next morning before the surgery. I have also removed my rings, all make-up, and all polish from my toenails and fingernails. I have also refrained from using any lotion, deodorant and powder on my body. I am not sure how I smell at this point.

Day of Surgery
  I don't sleep well. I never do. But I figure I will be getting some real good sleep in a few hours so I am not too worried. I get out my sheet that the Scheduling nurse has given me, and I take the medications she has circled for me to take. I also bathe again with the Steris stuff again and get dressed to go.
  We are arriving at 6 am and my surgery is scheduled for around 8:30 am. We go first to a holding area where I undress and get into my lovely hospital gown. My husband gets to stay with me during this phase. I spend the time teaching him how to get online at the hospital so that he can work on the computer while I am getting my new knee. After about two tries, I think he has it down. The time passes quickly. I learn from my nurse that mascara and fingernail polish are flammable. No worries there. I am totally naked in that department. After all, I don't want to take my chances with a stray spark from a drill.  In about 30 minutes The Husband and I say our goodbyes, and then I head out to the surgery waiting area.
   The surgery waiting area feels a little like a runway with planes taking off. It's a busy place. Every patient is assigned to a space that corresponds to the number of their operating room. The nurse asks you lots of questions, starts your IV, puts on your Ted hose, and goes over your allergies, etc. The surgeon comes by and marks your leg and gives you the final pep talk. Then the anesthesiologist comes. This is when I start to get a bit nervous. There is always a huge discussion that ensues because I have a weird allergy to Lidocaine, Benzocaine, and Novocain with Epi. I am hoping that I will be able to get the femoral nerve block. The anesthesiologist says it's a go. I am relieved until he shows up with two huge needles and two large vials of medicine.
       I say with confidence, "I will be asleep when you do the block, won't I?"
      He looks at me and says, "Oh no, I am getting ready to do it now."
      The panic starts to rise like bile in my throat.
      He catches my deer in the headlights look and says, "No worries, I am going to give you a little happy medicine called Versed before I do it."
     "Wait a minute," I say, "Versed works on memory, but I will still feel the pain."
     He pats my hand paternally and repeats again, "Don't worry."
  Another anesthesiologist has come over to join the party. He seems excited. I have my doubts. He has the doppler and is chatting away. The next thing I know they have laid me down flat, pulled my gown up around my chest (forget any shred of modesty I have clung to at this point) and seem to be doing something around the top of my leg. I feel NOTHING. He looks up at me.
     I ask him, "When will you do the block?"
     He pats my hand again and says, "We are already done."
    WOW. Strike one for the scaredy cat. I whiffed that one. And I even saw the size of the needle. I guess the Versed worked. I just hope the nerve block works. I really don't remember much after that until I woke up in my room. I know you have to be bored out of your gourd if you are still reading this. Syonara. More later.

Recovering

Recovering from a total knee replacement. Finding time in the surrounding silence of my house to pray and to worship. Learning to see that accepting the pain and doing the work of recovery can be offerings, acts of worship before a Holy God. It is also teaching me to be so very thankful for the small things.

Today my husband brought me a cup of coffee in bed. Made perfectly. It was an unexpected gift. I am still savoring the moment.

He also brought me an ice pack. It was better than french toast with blueberries or a bouquet of pink roses. It was divine!

Now I am ensconced on the sofa watching Jane Eyre. It doesn't get much better than that.

Rain for Roots: Katy's Story

Something must be up because The Daughter is back for a post!

I long for my children to know God, to experience His love, and recognize their need for a Savior. I long for them to bask in His light and love. I hope it is not a distant knowledge of a God way up in the sky rather a relationship with a God that would sacrifice His own Son to be close to humanity, to you, to me.

I personally love how music is a pathway to experiencing God. The beauty of lifting our voices to the Almighty is a powerful thing. It is truly precious.

I want my children to know how precious this gift is -- singing to our Lord and singing of our Lord. Let's be honest here, where do I find music that is on my child's level but does not bring my sanity into question? Most children's music is either over-produced or so cheesy that I can only try to listen to the entire product knowing that I will toss it after that initial experience.

I sat down with a dear friend, Ellie Holcomb, to discuss this dilemma. I gently, maybe not so gently, urged her to start making music that I could share with my own child. She mentioned that some "talk" was happening amongst her music community. She teamed up with some other dear folks (Sandra McCracken, Flo Paris, Alice Smith, and Katy Bowser) and came back with the product below:

Head over to Rain for Roots to buy it (for only $8!) and enter 'truelove' for a 10% discount on the album (that makes it $7.20!), available to all my readers!

Please listen as this product is a keeper! Music that will take you and your children to the feet of Jesus so you can bask in His justice, mercy, and love. What a treasure!

I also am leaving you with some sweet words from Katy Bowser about this special project (if you want to hear from the other gals who worked with Katy view the links at the bottom of this post).

1) Which is your favorite song or Story's favorite from the CD? Why?

I wrote the music to Baby Moses while rocking my baby daughter Story to sleep, so it is truly a lullaby!  I still sing it to her almost every time I rock her before she goes to bed, and she asks for it.  "BAY-beeee. BOOOAT."  It's a wonderful reminder to me, too, like all of the songs.  I often sing this thinking of God rocking me in His arms, as well, God who knows just what a baby (and her mama) needs.

2) What memory do you hold dearest from this process? Any funny details/stories about the recording process?

 It was truly special for Sandra McCracken, Ellie Holcomb, Flo Paris, Alice Smith and I to take Sally Lloyd-Jones out to our favorite neighborhood cafe and talk to her about the possibility of this project.  She immediately felt like a friend, and there are so many little moments that I treasure from talking that afternoon.  Sally talked about how often when God is doing something, it feels like a treasure hunt, like following bread crumbs as we watch and listen to what He is doing.  Is it any wonder she writes stories that big and little people love, when she talks like that?

As for funny details, this is the first project where I've recorded with my daughter literally at my feet or in my lap. You may notice some additional background vocals throughout the recordings. My husband Kenny Hutson played a number of instruments.  This truly felt like a family project with Kenny, Story and the rest of our extended family of friends.
3) What inspired this project?

I think Alice Smith that it came together over cups of tea.  I have a kid's jazz project called Coal Train Railroad.  Ellie Holcomb called me up with the thought that perhaps I could also be writing scripture songs for little ones, and I had begun to do just that. Meanwhile, Flo had begun to do the same thing, Alice was excited about the thought, and Sandra and I had started to mull the thought over.  Big thanks go to Lisa Rohrer, our friend, for saying, "Have you seen Sally's Hug-A-Bible?"  It was the perfect starting point.  It does such a wonderful job of saying big ideas in little words.  God is the One, the Hero.  From here, we plan to put melodies to scripture.  We want to tuck lots of very true truth deep down into the hearts of little ones.  I've never forgotten the little scripture songs I learned as a child, and I want to help make many more of them for many children to hear.  I can think of few better ways to love the church in the coming years.

4) Who are the kiddos that sing along in the recording?  

All of our little ones.  Whoever was feeling gregarious, musical or just very much wanted to be very near their mama when we happened to be recording. These are the hazards and rewards of being a musician's child.

Anything else we (the listeners) should know about the project?  This is the beginning.  We've been so delighted, amazed at the unbelievable word of mouth thus far.  This feels, as Sally, said, like we're just following the breadcrumbs and watching a very good Story that God is telling unfold.  What a joy to join in!

Read Ellie's Story at Designs by Stephie
Read Flo's Story at Nala's Photography
Read Sandra's Story at Life: Edited
 Read Alice's Story at The Musician and the Geek

How Could I Forget Thee?

"Can a mother forget the baby at her breast and have no compassion on the child 

she has borne? Though she may forget you, I will not forget thee. See, I have 

engraved you on the palms of my hand." Isaiah 49:15-16

 
     No mother would ever forget her child, for once conceived, a mother's children are hers forever. Yet the Lord makes it clear that His love for us exceeds that of a mother for her child. How can it be? And yet, He tells us again that no man can fathom the depth and heighth and breadth of the magnificent love He holds in His being for each of us. It is a love that defies description. A love that extends beyond all measure. It runs so deep that it forever scarred the hands of the One who gave Himself up for us. Even Isaiah who gave us these beautiful words could not have imagined the terrible price it would cost Christ to "engrave" us on the palm of His hand.
   Every mother alive would shudder to think of those selfsame nails piercing the hands of any of her children, yet that is precisely what happened to the Only Begotten Son of God. And it was love that compelled Him to go to that cross. Love for for you and for me.
   I began this Mother's Day by being thankful for my own Momma and her many sacrifices of love that have enabled me to become the woman I am today. It was she who rejoiced with me over the impending arrival of each little one; it was she who came at every birth and tenderly taught me how to love and care for my babes; and it was she who has supported and championed me at every turn of my life as a mother. I owe her so much.

   My heart is also filled to overflowing as I consider the treasure of the three sons and one daughter who have afforded me the priceless treasure of being a mother. There are no words to express the joy I hold in my heart for them, as well as for their wives and husbands. Daily I am also thankful for the joy of being a grandmother to Little One, Little Two and soon-to-be here Little Three. These little people are teaching me so much about the faithfulness of our God!

    Yet it is to the Lord Himself that I owe the greatest debt and the one debt that can never ever be repaid. For it is He who has given me and those I love life and breath and everything else. They and I are engraved on the palm of His hands. Those beautiful nail-scarred hands. It is simply too much to comprehend.

A Prescription for Hope

   I have been in two radically different worlds this past week. In one I visited a country steeped in antiquity that understands the important lessons that can be learned by the careful preservation and investigation of the past.
   In this other world, I traveled to a place that seemed bounded by the realm of possibility and a dream for the future. A world where the finest technology that man has developed in the fight against a specific disease travels side-by-side with compassion, kindness and the dispensation of hope. Where have I been in the space of one week?  I have traveled from the country of Italy to the hallways of MD Anderson Cancer Center. Both are places that will remain indelibly imprinted on my mind and heart, but for very different reasons.
   I am not unfamiliar with hospitals and medical centers. I live in a relatively large urban center (for the South), and we have a world class trauma center, a world class Children's Hospital, not to mention a world class heart center, but to enter the world of MD Anderson is to go to another planet...something seemingly out of this world.


   The sheer magnitude of the size of the complex is staggering.  More than 50 freestanding buildings in Metro Houston comprise what ranks as the world's largest free-standing cancer center. And with over 18,000 employees, 6100 trainees, and 1100 volunteers, MD Anderson has assembled a highly trained army to wage war on a terrible foe.
   Given the nature of the beast that the folks you see in the hallways are battling, you would not think to find this to be such a place of peace. Yet it is. Not only does peace reign, but kindness also abounds. Almost every staff person I met greeted me with with words, "How may I serve you?" accompanied by a smile. And wonder of wonders, it did not feel stale or obligatory, but rather heartfelt. I was amazed. Even the doctors don't duck their heads to pretend you don't exist. They look you in the eyes, smile, and more often than not, say "Hello, how are you?" Definitely not the norm.
   Over the course of the week I talked to nurses, techs, and volunteers who told me that there is a huge emphasis on patient and care-giver interaction with all levels of staff receiving continuing education about "the service, compassion, and dignity" that is to be afforded each individual.
   It shows. From the Jolly Trolly that rolls the hallways dispensing free coffee, hot chocolate, lemonade and tea to the convenient Post Office, hair salon and library stacks that are open and available to patients and care-givers alike.
   To achieve the level of service that is pervasive at MD Anderson is not accidental. It is obvious that a strategic hand has been at work. Surgical Waiting Areas are arranged around a common theme: ours were flowers. Since we were there on surgery day for twelve plus hours, we spent time in both the geranium and daffodil waiting areas. There were round tables for working puzzles or card games, along with an ample supply of current magazines as well as a lending library.  Warm blankets were offered without having to ask for them, the lighting was soft rather than harsh, and the pods were small enough that no more than three families were in each little area. There was a soft murmur of conversation as families came and went escorted by the kind and compassionate volunteers who checked in every hour to be sure that needs were met. The common battleground brought families together.  Shared stories, prayers and encouragement were the norm. Despite the gravity of each family's situation, there was a shared camaraderie. In the space of a day, we met two different families with daughters who were undergoing brain surgery for the relatively rare Cushing Disease. I now know more than I ever dreamed I would know about this disease.
  And yet. There is this intangible thread of hope that encircles all who enter this place. The finest minds, the finest technology and the finest care have all been assembled in one place to wage this war. The MD Anderson website perhaps says it best. I pray that by God's grace, they will find success.


Mission
The mission of The University of Texas MD Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.


Vision

We shall be the premier cancer center in the world, based on the excellence of our people, our research-driven patient care and our science. We are Making Cancer History. 

Core Values

Caring: By our words and actions, we create a caring environment for everyone.

• We are sensitive to the concerns of our patients and our co-workers.
• We are respectful and courteous to each other at all times.
• We promote and reward teamwork and inclusiveness.

Integrity: We work together to merit the trust of our colleagues and those we serve.

• We hold ourselves, and each other, accountable for practicing our values.
• We communicate frequently, honestly and openly.
• By our actions, we create an environment of trust.

Discovery: We embrace creativity and seek new knowledge. 

• We help each other to identify and solve problems.
• We seek personal growth and enable others to do so.
• We encourage learning, creativity and new ideas.

I hope you never have need of this place, but if you do you will quickly discover that MD Anderson is the best in the world. They mean what they say: Making Cancer History.

The Gastronomic Italian Adventure

 
    You cannot talk about Italy and not discuss the food. I loved the beauty of the Italian scenery, art and architecture. Each day that we spent in Italy, I was reminded of the majesty and diversity of both God's creation and the gifts He has bestowed upon His creatures. Yet Italians have certainly elevated food to an art form. Dining is an experience that incorporates all of the senses and is, perhaps, a sacramental element to life in Italy. In 10 days of travel, we did not have a single bad meal. And some of the foods that we ate will be remembered as the best I have ever eaten. But it's not just the food, it is the entire experience.
   You sit down at an Italian restaurant and you wait. Be prepared. Americans are not used to this "breathing" experience where you settle in to the climate of the restaurant. You are expected to begin the process of relaxation as you begin to prepare yourself mentally and physically for the meal. After what often seems to Americans to be an interminable time, the waiter carefully and gently either catches your eye or approaches your table. They are always careful to give you your space; you are never rushed or pressured in a meal in Italy. If you are not ready to order, fine. You are welcome to sit there for as long as it takes.  Italians do not understand the American concept of "turning" a table. Your table is your table. You can stay until the place closes if you wish.
   The Husband and I have learned to carry a bottle of water everywhere as it never pays to enter a restaurant thirsty. You are almost always expected to sit for a bit before they will approach you about the beverage service, so if you are dying for a drink don't expect to be served quickly. Quick service is not in the Italian vocabulary.
  After ordering your beverage, you may wait a bit longer. Relax. You will not be asked to place your order until you have closed your menu and put it to the side. Sometimes the server will bring you bread. Other times, you request it. We always asked for olive oil and balsamic vinegar to accompany our bread, as well...oh, and we always asked for a plate because they will do exactly as you ask: they will bring the bread basket, the oil and the vinegar but you will have no place to dip it...so request a plate!

   The Italians eat a lot of food, but I never saw any obese Italians. I don't know how they do it. I watched the Italians around us, and they were generally eating three or four courses at every meal accompanied by wine, an aperitif, and coffee. Granted, the meal was taking 2-3 hours to consume, but it was still an enormous meal. Ed and I sometimes managed two or three courses (including dessert), but we never made it to four courses.

   The Antipasti is usually cold. It's ham (pruschutto, pancetta, etc.) and melon or cheeses, salami, sometimes shrimps (they use the plural form) and calamari or octopus (if you are in a seafood town). The best antipasti course I had was a "duck" ham with a terrine of cauliflower accompanied by a pear chutney. I could have eaten it every night I was in Italy, and I am not a huge fan of duck. Or at least I wasn't until then.

   The Primi Piatti or first plate is usually some form of pasta. We sometimes found that it was large enough to split, and they never object to bringing you two plates and utensils if you ask. We often found that this first course is usually a generous enough portion to serve as a meal in itself by American standards. However, in Italy, they do not want you to order just the first course. You are expected to order the Secondi Piatti (second plate) as well. So get ready...for this gastronomic adventure you will need to pace yourself. Be sure to ask your waiter the special pasta fresca (fresh pasta) for the day as that is always the best way to go. Fresh pasta in Italy is nothing like the fresh pasta I have had in America. It literally melts in your mouth. I don't know if it's the flour or the semolina, the butter, the eggs, or maybe all three. One lasagna dish The Husband ordered had 15 layers of tissue thin pasta and a bechamel meat sauce...divine!

   The second course (Secondi Piatti) is meat. It may be veal, shrimp, beef (if you are in Florence) or fish. You will also have a variety of choices for sauces as well. You usually order sides with this course called Contorni. I don't know if it is in deference to American tourists, but in Florence almost every menu had french fries listed under contorni. Be sure to tell them that you would like the side with your second course.

   I usually think of Americans as beef people, but the Florentines give us a run for the money with their steak known as Bistecca alla Fiorentina. They serve these giant T-Bone steaks from this special breed of cow known as Chianina. The steak is prepared very simply: salt, pepper and garlic and is cooked over a wood stove. The outside usually has some char but the inside is rare and succulent. Lemons are served as the garnish and all of the Italians I saw squeezed the lemons all over their meat. The piece of meat is HUGE (and a bit pricey), but The Husband finished all of his very nicely. He did afford me a bite, and it was delicious.

   Pizza is another menu category all together. The pizzas differ by region in terms of thickness, sauce and cheeses. Southern Italy  (Naples) is famous for its pizza which is the thinnest of the pizzas, but I loved all of the pizza we ate in the Tuscany region.  My favorite had to be a pizza with smoked cheese called scamorza, the likes of which I had never tasted. It was divine.
   Since I am a cooking channel aficionado, I had heard about this Italian bread soup called ribolitta which serves basically the same function as gumbo in the South. It is really more of a stew than a soup and incorporates all of the leftover vegetables and stale bread. I ordered it at the end of our stay in Florence and was not disappointed. It was hearty and very filling and could easily have sufficed for a meal had it not been our last evening. My tasty ribolitta had beans, peas, kale, onions and possibly cabbage or potatoes along with chunks of the requisite bread. To be honest, I was hard pressed to identify all of the ingredients, but it didn't really matter. My bowl was wiped clean.
   
       No trip to Italy would be complete without a daily dose of gelato. The Husband religiously followed this rule. It's hard to believe, but I am not a huge fan of ice cream so I passed most of the time, but I made up for it by eating the weight of one leg in tiramisu. I also had at least two cappuccinos every single day. It was for my mental health. And my caffeine addiction.

  By far one of the best things about eating in Italy is seeing the joy that the Italians have when you express your genuine appreciation for the meal. In several cases, they brought us additional food to taste or served us a glass of limoncello as a way of saying thank you.  We left Italy satiated in body, heart, and spirit. The beauty and generosity of the country and its people were like a fine wine...best if savored slowly so that the memory and the taste will linger.

Italian Adventure Part Three

     The Husband loved Florence. I knew he would. It is much more manageable than Rome and is a perfect size for once intrepid travelers. We slept like babies in the Bernini Palace Hotel on our linen sheets. I've never slept on linen sheets before. Now I can say that I have. They supposedly help regulate body temperature and breathe with you. Whatever. It worked. As soon as my head hit the pillow each night I was out like a log. And if the snoring next to me was any indication, The Husband experienced the same.
     The weather was also perfect. Cool mornings and evenings and highs in the lower seventies. And that glorious Italian sunshine.

The famed Duomo. It's just as magnificent as you think it would be. It's two domes really. Brunelleschi executed this amazing architectural masterpiece by building a dome inside a dome. There's a stairway inside. It's redolent of a metaphorical stairway to heaven. The Husband climbed all 886 of the steps. He said he sweated like a pig and got a little claustrophic. Thankfully, I kept my own feet on the ground and visited Michaelangelo's Duomo Pieta while he was toiling away. We were both happy campers.
   It's a long way up there.

This is the view from the top!

This is not a picture of the Florence Duomo's Pieta, but these iron rings are everywhere in Florence. They are definitely not a one of a kind.

However, this is:

I have now been blessed to have seen two of Michaelangelo's Pietas...

one in Rome and one in Florence. Each is magnificent in its own way.  

While the Pieta in St. Peter's is more finely finished and was likely executed when 

Michaelangelo was at the height of his powers, this one has a roughness that lends 

it a particular pathos. Carved later in Michaelangelo's life, the Florentine sculpture reflects his understanding that he was nearing the end of his own life. It is said, as well, that the hooded figure on Nicodemus is cast in the likeness of Michaelangelo's himself. I stared at the face forever trying to get some sense of the man, but it was the face of the Christ that kept calling to me.

We just couldn't get enough of the Duomo 

This was the breakfast room in our hotel

And this is the lobby

Are you surprised that I'm ready to go back?!

And this is the lobby

Italian Adventure Part Two

   Venice. The city that defies description. Home to Marco Polo, Vivaldi and Bellini. Immortalized in Shakespeare's Merchant of Venice and Othello. The floating city. The Bridge of Sighs. Glassblowers and lace makers extraordinaire. Ancient gondolas glide alongside modern vaporetti. The masks and costumes of the Carnival vie for tourist Euros with the vaunted purveyors of high fashion. The worlds collide, overlap, and flow together. They move in tandem with the water. Life in Venice is eternally bounded and defined by the blue green seas that ceaselessly lap against the buildings.
   Make no mistake, this is a city of extremes. It polarizes visitors. One is either entirely captivated by the romance and the sense of timelessness or one feels disoriented, confused, and eager to escape its labyrinthine passageways. I fall into the former category. History. Art. Architecture. The provocative and creative marriage of Byzantine, Rococo and Moorish forms. Maze-like streets that seem to turn inward upon themselves. Water, water, everywhere. And overriding all a pervading sense of mystery. This is a city of endless secrets. For me, a romantic at heart, what is there not to love?