Friday, November 21, 2008

Week Two, Convalescing at Woodrose

Moving to the Woodrose Club was such a welcoming next chapter in my healing process. Ruth and I were shown into a small yet comfortable room. The twin beds were extraordinarily comfortable, plus we had a balcony that over looked the well cared for grounds. Two Indian men were mowing the grass with an eletric mower. One mowing, the other disignated "keeper of the cord." Behind them a beautifully attired Indian woman squatted behind them sweeping up the clippings with a branch. She was so effective with this method. Can you imagine squatting for hours, actually moving with her feet on the ground, sweeping at the same time? It hurt my knees looking at her and yet her dexterity was remarkable.

This place is a Mecca for the well to do able bodied. It sports a gorgeous swimming pool, tennis, badminton, ping pong, and racket ball courts, with full weight room and aerobic exercise equipment. It’s a beautifully laid out complex, with long walkways of black granite tile, gardens, stairways, and something we were really looking forward to after a week of hospital food, an excellent restaurant.

My appetite had returned. That first breakfast of fresh squeezed grape juice, omelet, toast and jam was gobbled down with gusto. I’ve been an avid coffee drinker for decades but somehow in India, I’d lost my taste for it and shifted to a bonafide tea drinker.

My only responsibity here was to heal. I returned to the hospital daily for PT. I was transported via taxi. It was less than two miles, but what a daily ride this was for me. The traffic in Bangalore is atrocious. The streets are clogged with cars, trucks, busses, rickshaw taxis, scooters, bicycles, cows, and ox drawn carts. It is pure madness. Pedestrians have no right of way. And as Ruth discovered, Bangalore has the worst side walks in India. The only way a pedestrian can cross a street is to find others and as a team, wind your way through the maize of traffic. Individually you’d be road kill but with three or four joined together you have a slightly better chance of reaching the other side in tact. This was not my fate to experience anything so daring. But just riding in a taxi through the throngs was a full day’s entertainment.

The PT at Wockhardt was challenging and just the spurt of energy I needed to recoup some of my waning strength. The ladies who guided me through the daily grind were young, fun loving and serious about the importance of establishing a good routine of strength and flexibility exercises. Everyday they pushed me a little harder. I seemed to be omproving most days, though still painful, but a few days were still excruciating; the pain in my knee was raw and unbearable. On those days they worked me a little easier. This would be a good model for the long haul of future rehab and healing.

Back at Woodrose, the dining was the highlight of the day. Great soups, salads, and spicy Indian cuisine were there for our dining pleasure three meals a day. Almost immediately we both started having “watery motion.” At first it was quite welcome to clear out the pipes from the week of hospital sluggishness. But after a few days of mild to moderate diarrhea we started rethinking our food choices. We eliminated all the fresh produce from our meals. This made no difference. I even backed away from the restaurant and bought cereal and yogurt from the commissary, but this also had little effect on my body’s purging. A week of this is going to be plenty.

The festival of Devali, the goddess of light happens in India the last part of October. This is the biggest celebration of the year and it goes on for four days. One of the recent trends in the celebration is the lighting of “fancy crackers.” It used to be sparklers and colorful fountains but in recent years the entire city goes crazy with loud booming explosive fire crackers. The blasting goes on for hours. The working class of India, whose average salary is about $150 a month, spends millions on these banal explosives. It really sounded like a war being waged from our hotel room. Fortunately Ruth never travels without ear plugs, so we witnessed this famous Indian celebration hunkered down in our room, attempting to muffle the deafening sound.

The festival of Devali is also celebrated by lighting oil candles. The restaurant was beautiful as these whispers of light lined the window cells and perimeter of the gracious room. Ruth and I were the only ones in the restaurant this particular night. We were seated right by the window looking out on the courtyard that was also lit up with colorful lights. The place was really slow during the holidays. I was not feeling well and ordered only a seven-up for my dinner. This was Ruth’s birthday and she was feeling a little let down partly because I was so self focused on my painful condition and there was no sense of celebration honoring her day. Our conversation was strained so with a feeling of heaviness I got up to return to our room. My long hair brushed into the lit candles and unbeknownst to me, provided additional fire works. Ruth fortunately noticed that my hair was on fire and immediately smothered the flames with her shawl. It was quite comical, but I found no humor in the event. My nerves were shot from the trauma of surgery, and painful recovery, and I went into shock realizing just how close I came to utter disaster. When I got to our room, I covered my singed, stinky hair with a bandana, took a valium sleeping aid and curling up in the fetal position, rocked my miserable self to sleep.

The next morning, after a very good night’s sleep, we were able to talk about how each of us was feeling. At this point I could laugh at the previous night’s debacle, and thanking her from the bottom of my heart for her quick saving action, we both felt relieved and back on our sisterly track.

Most of this week at Woodrose was spent resting on the comfortable bed, writing and reading e-mails, reading this great book, Shantaram, about an escaped convict who flees to India. He falls in love with Bombay and relays one extraordinary tale after another. It's written by Gregory David Roberts, and is a book I highly recommend. Not being able to seek out adventures myself, ( are you kidding, I couldn't even stray far from a toilet!) I found great delight in reading about another's love affair with India.

The Salon at Woodrose proved to be excellent in the treatments offered. I went in for a pedicure. It was such a healing experience. The ladies working there were from a northern state in India, they were Oriental looking and just exquisitely beautiful. They were completely present in the treatments offered, and so attentive to my well being and comfort. I availed myself to their healing hands receiving facial, scalp massage, and manicure each on a different day.

One of my main concerns during this week was how I was going to handle the return passage to home. I still could not bend my knee comfortably. Mostly I needed to keep my leg up on the bed or chair as the pain became really intense when I sat for any length of time. Our trip home would take place starting on Tuesday Nov. 4, Election Day. This was exactly two weeks after my surgery. Ruth wisely counseled me to not dwell on this future event but just take each day as it comes, and work at increasing my range of motion. The day before we were to fly home I had the staples removed from my incision. There it was, this Frankenstein scar, six inches in length, tight and sore. I was instructed to keep the wound unbandaged and allow the fresh air to aid in healing. My last day of PT they had me lay on my stomach, which felt really weird and uncomfortable, and had me bend my knee back beyond 90 degrees. The young therapist who I’d worked with some, assisted this stretch really cranking on it, a bit too aggressively I felt, but got it to bend further. I was told to add this stretch to the repertoire of exercises they had established for me. Of course my knee responded to this extreme bending by swelling up good and stiff, with the pain increasing. Just what I needed before I traveling. This was the last of my guided time. From this point on I was on my own to heal and continue my strengthening and rehabilitation. But first I had to undergo the long journey back home.

Friday, November 14, 2008

A Week of Care at Wockhardt Hospital



It felt good to be back in my own room. Ruth was certainly glad to have me close by where she could keep an eye on me. Dr. Sanjay Pai burst into the room with his entourage of junior surgeons and charismatic presence. “Your knee was the worst thing I’d ever seen for a woman your age. The repaired ACL was crumpled and torn, it was a mess. This is why the surgery took longer than I assumed. And as for your R knee, don’t waste your hard earned money on anything other than a full replacement when the time comes to do it. The x-ray shows that everything went extremely well. Now it’s up to you. I will send in the physical therapists and you can begin your rehab. In the United States you would be preparing to go home by tomorrow, here we look after you for at least a week.” Then he was gone.

I was bed bound with a catheter, my knee somewhat numbed by the epidural line with pain medication administered through a connected canister. I was also receiving oral pain meds, along with anti nausea, and anti vomiting meds every few hours. Sam & Sally the PT’s walked in and introduced themselves. I was instructed to roll a towel and place it under my knee, then tighten my quads and push down with the back of my knee into the towel. This movement elicited a soaring pain, really rough and raw. Then with my leg flat on the bed I was instructed to focus on my heel and move it smoothly up to form a painful bend then down again, back and forth. Then lastly they taught me to roll over on my right side with a pillow between my legs for support and sleep and rest in this position to give my back side a much needed break as I’d been lying in this position for 24 hours or more. They were both extremely professional and unhurried. The Doctor’s rushed in and out but the PT’s were there to spend time, explain the healing process, field my questions, and establish from the get go a strong physical therapy program.

As the hours ticked on I was feeling queasy and weak, with sleep my only relief. Food was brought to the room but I had no appetite for anything other than water and the apple juice the hospital provided.

The next day the nurses bathed me. Being helpless and bathed by an empathetic care giver gives one the feeling that there is infinite kindness in the world. Sam came in and showed me how to use the walker which in turn allowed the catheter to be removed and I was now free to roam about my room. As the day progressed, so did my nausea. It was very miserable. I realized that I was experiencing the effects of all the strong pain medication I had been pumped with. This condition of extreme nausea is no doubt what the hospitals protocol tried to prevent, by not administering the copious amounts of drugs I needed that first night in ICU. Ruth got on line and researched my symptoms, and it was suggested to get off the drugs before a chronic condition of nausea sets in. So I told the nurses that I wanted to lay off the drugs for a while. They obliged and said to ring the bell if I needed anything. The pain was still tolerable because of the epidural medication that kept my right leg numb.

The epidural was removed 72 hours after insertion to prevent infection. As the sensation returned to my leg, the deep soaring pain became extremely acute. An internist came in and recommended returning to oral pain meds and shots through my IV port, upon request. So I was going back and forth between lots of pain meds, then none, kind of a yoyo game, but I think the 20 hour reprieve helped to get my system cleaned out enough to mitigate the upset condition I’d been enveloped in.

But pain is the name of this game. I thought about what it would be like to have had both knees replaced and I absolutely shuddered to contemplate twice the pain and the compounded condition of having two fiery hot legs to rehab and get around on. There’s absolutely no way I could have handled anymore than what this one knee was inflicting.

By day five the nausea was abating and I felt the first desire for food since surgery. The meals would come up from the kitchen regularly. Deepa is the kitchen manager of the hospital. She would make her daily rounds checking in and taking requests from her kitchen. Mostly the food went back hardly touched. It felt cruel to be wasting this food knowing that just outside this building were thousands of people not to mention feral dogs who would so appreciate this sustenance. So Ruth took it upon herself to bag up the uneaten scraps and would make her daily rounds outside to feed the hungriest dogs she could find.

Describing human functions on a personal basis is much easier through a key board. I've been unable to "pass motion” since the traumatic experience of surgery. Everyday the sweet nurses have asked and as the days have ticked on to number five I've had to admit that my bottom is locked up tighter than Fort Browning. I haven't had much of an appetite so the problem hadn't dominated my efforts. But yesterday I knew it was time to move this mountain. In the morning I requested a suppository. An hour later with not so much as the sound of gas to prove efficacy, I asked for an enema. At home I love enemas. I went for6 months and gave myself coffee enemies most mornings. It gets the days going off with a literal blast. The enema that was brought here however was this small tube of clear jelly that the nurse implanted in two seconds. Still nothing.......So now the Doctor's are taking an interest and asking me every time they make their rounds. Have you had motion yet? One of the nicest Doc's suggested MOM's remedy, Milk of Magnesia. I've also had problems with indigestion and heart burn so this sounded like a welcoming approach. I drank a good jigger of it, slammed down a quart of water, and still.......nothing. This was getting serious. Chemicals and drugs have had full reign of my innards for almost a week now, I'm feeling toxic and bordering on desperate to eliminate. So last night I asked the nurse if the hospital contained somewhere in its hidden places an enema bag that I could use on my own for the evening. "Ohhh" she said, shaking her head, "that's the old fashioned way. I haven't seen one of those in years." Well please inquire if there is one still hanging around please. This is what I need to solve my dilemma. She retuned an hour later, beaming. She had a stainless steel canister with tubing attached at the bottom and yes an insertion point. She wanted to help me but I begged her to just let me be. We have a small coffee maker in our room so Ruth got some hot water going with our filtered water. I won't go into all the details. But trying to have an enema with only one functioning leg and a small bathroom with no room to stretch out and let the water flow presented it's share of challenges. No one would ever confuse us with McGuiver but Ruth was totally devoted to this project and I can say that this morning I’ll have a positive response to this question of motion.

After enema magic, my energy picked up. Releasing all the toxicity of surgical trauma and drugs brought renewed vigor to my aching body. I really started looking forward to being released from the hospital and checking in to the Wood rose Club. Tonight was Pizza night at the hospital. Gosh but the thought of Dominoes Pizza and a coke got the juices flowing.


As the week in Wockhardt was coming to a close, I felt so fortunate to have had such good care from so many skilled and compassionate care givers. Early in the week Sam, my PT came in with the x-rays of my knee before and after surgery. It was such a remarkable picture. My knee which was crippled with arthritis and painful bone on bone was replaced with this rock solid bionic joint. Again I feel just so lucky that this procedure was available to me.

Suhas came in the last day to take us to Woodrose. I asked him if there were any other charges from the hospital that had accrued throughout the week. He assured me that the $7,000 I paid covered everything. It is remarkable and in sharp contrast to the medical costs we pay in the States. For $7,000 the hospital provided transportation to and from the airport, all of my pre testing including x-rays and MRI’s for both knees, my surgery and night in ICU, a week of care in a very gracious hospital suite with meals for both Ruth and myself, all of the medication including enough for the week at Woodrose, Physical Therapy everyday and a Walker and Cane.