Tuesday, June 28, 2011

Balloon Tennis: Serious Work?

“Alright, Ladies, now you’re going to play balloon tennis.” Brian, who told me he has a Master’s degree in Occupational Therapy, was talking to me and another patient; we were both in the therapy room to work on upper arm strength. We had just finished 20 minutes of hand pedaling during which I had challenged Ruth (the other patient) to a race, and we both went at the same good clip until she suggested it we call it a draw.

I liked her right away – because of the way she held her head up high and expectantly, her big smile and twinkly eyes. She is about ten years older than I am and is ready for whatever the day brings.

She giggled a little at the mention of a balloon, but seemed ready to give it a try. I, on the other hand, was groaning inwardly, thinking it sounded like a waste of time. How do you strengthen your arm muscle with a ping pong-sized plastic paddle and a large red balloon?

But Brian explained it was also about endurance and balance in standing. I continued my inward conversation by chiding myself about being both dismissive and unwilling. “Just go for it, Donna Jean,” I said to myself. “Brian is the expert, and it just might be fun.”

I have never played real tennis and as a teenager, and I was a total washout with table tennis. However, at age 82, my brother David still plays doubles weekly and is a fan of the sport. With him, I have seen the best and most athletic players in championship matches on television. I had learned a few of the rules and always admired their grace and strength, so I called up a mental picture of how they hit the ball.

Ruth was ready to go, and I could sense a little competitiveness. We were both standing in the safe semi-circle of our walkers--about six feet apart. Two therapists were standing on either side, our four bodies making a square.

Gradually we each got better and increasingly competitive – even aggressive. If the balloon veered to the left or right, the therapists would bat it back to the center with their heads. Ruth tried for a volley and I matched her paddle work and returned fire – we kept it going for a half-dozen hits.

I began to feel warm and wanted to shed my jacket, but I didn’t want to lose momentum. Soon I felt a little trickle of sweat at the edge of my hair. Ruth looked cool and determined.

It is hard to control a balloon, and we all laughed a lot at odd gyrations and very clever moves to volley. And all the while we had to pay attention to how we were using our bodies to keep up our endurance and maintain our balance.

Not much of rehab is fun. The therapists are spirited young people who smile frequently and offer encouragement even as they demand corrections in order to maximize a stretch. It is serious work we are all doing together and, for the patients, it is directly tied to future quality of life. Even with the aid of painkillers, it hurts. Bending that knee a little further with each heel slide or straightening it more with a quad set is painful. It feels almost perverse to me to inflict a little more pain with each repeat.

Asked by a friend how it was going, I responded that it is trying, in two senses of the word. I am striving to do the best I can, and my determination, performance and ego are constantly being tested. Balloon tennis turned out to be a respite.

Maybe we’ll have some more matches, and I won’t drag my feet next time. In fact, Venus and Serena better watch out. Two gray-heads with walkers and balloons just might be closing in!

Tuesday, June 21, 2011

Knee Action: I Believe In Miracles

Sunset from my Asheville hospital room
(this is not the Biltmore Camera Channel).

On the third day I was in the hospital renewing my knee action*, my son Robin found a list of TV stations with channel numbers. Since I had been sleeping most of the time, I hadn’t paid much attention to the world beyond Room J614 at Mission Hospital in Asheville. I was glad to have a guide to help me find the evening news. As I scanned the list, my eyes stopped when I saw “Channel 19: Biltmore Camera” followed by the letters of a radio station. 

Curious, I clicked on the “1” the “9” and “Enter.” Up came a somewhat static view of the Biltmore Village shopping area; a radio feed pumped out “I Believe in Miracles,” but none were visible on the screen. I could see the spire of All Souls Cathedral, and the I-40 overpass bisected the top third of the picture, while Biltmore Avenue was the off-center axis. It was not a good picture and one corner was fogged or blurred. I could not detect signs of life like moving cars. There was a good bit of greenery and a nice chunk of sky, but the weather was overcast and the Biltmore Camera Channel was rather blah.

Robin and I decided to check it again after dark. There aren’t many good entertainment options when your brain is fuzzy with pain medication and your legs are out of service because someone sliced your knee open, messed around with a bunch of tools, and then stapled it shut. The same Biltmore scene was just barely visible in silhouette and there was a horseshoe of street and security lights around the Biltmore Village Shops, but no moon to say good-night to.

Some small problems taken together resulted in a two-day extension of my hospital stay so I was able to make good progress in my physical therapy. On Sunday, the therapist decided to take me for a longer walk down a corridor guided by a walker and impeccable instructions on how to develop a smooth gait. Then a right turn into a cul-de-sac to look out a picture window--and there was the Channel 19 vista in very good focus, and minus the fogginess in the right-hand corner. It was also very quiet without the radio feed. I was so tickled, I almost glided back to the room.

My last week has not produced a static picture as I finished last minute preparations, had a surprisingly good dinner at a pub in Hendersonville, and spent the night in Asheville so I could be on time for my 5:00 AM hospital check-in. There I passively and prayerfully submitted to the works of a surgery team, a recovery nurse, and a cadre of professional caregivers who got me through the hospital days feeling safe and in many ways validated my choices. Yesterday, I moved to a rehab facility with a new window where my view includes mountain greenery, an American flag, and a parking lot. The soundtrack is the beeping call signals for the nurses, the soft hum of conversation, and the noise of walkers clacking up and down the hall. 

I’m glad I’m not in a reality show, and I’ve been a little reluctant to write about this particular experience. But right now, this is my life and I am the webcam.

*A word about “knee action.” When I was a child, my brother loved to go watch hucksters on the oceanfront boardwalk selling kitchen gadgets that would make vegetables into adornments for plated dinners. Once it was a combination potato peeler and slicer for making Frenched green beans. The salesmen kept saying, “It has knee action, knee action.” David pestered our mother to buy it, although none of us knew what knee action was. After I was able to start walking the hallways, Robin said, “you need to e-mail your brother and tell him that you finally have knee action.” 

Tuesday, June 14, 2011

Renewal: It Comes in Many Forms

My son Robin and I have been learning about knees as we met with the surgeon and attended the knee class at the hospital in preparation for my forthcoming surgery. We both thought a knee replacement was just like hip replacements in which they remove the deteriorated joint, trim off the bones and put in a new joint mechanism. The surgeon started off his explanation of the knee replacement by saying that it is actually  like capping a tooth. At Robin’s request, he brought in a model and explained how they shape the ends of the two leg bones and then cover them with titanium caps. They retain the kneecap but insert a pad of a plastic material that does the work of the worn-out cartilage. I asked the surgeon if he was really a sculptor and he replied, “No, I am more of a carpenter.”

Along with my daughter-in-law Tammy, we have been checking out the knee sites on the Internet and picking up all sorts of information including the fact that at first the operation was performed mostly on older people and the chief reason was pain abatement. As the population became more athletic,   people in their forties and fifties have wanted this surgery with the intention of returning to a very active sports-oriented life. It seems to me that the physical therapy programs now available post-surgery are responding to that younger demographic as well as the one I represent. They are definitely designed  to get patients as active as they can —or maybe as they want to be. I'll be happy for the pain abatement but my real goal is to resume walking a mile a day.

It feels to me like everyone I know has either had a knee replacement or they have friends or family members who have. I’ve heard stories that run the gamut from, “Not a big deal, no pain at all, didn’t take pain killers” to “Hurts like Hell and be sure to take everything they give you for pain.” Many people in church, at the grocery store or in my living room have pulled up a pant-leg, or even two, to show me their scars. It won’t be long until I’ll know where on the spectrum I’ll be, but I am persuaded that the medical community takes this procedure very seriously, and precautions against infection and falls are heavily stressed.

Some weeks before I embraced the idea of a knee replacement, I contracted for a siding replacement operation on my house. The rustic hemlock siding that Bill had chosen some 33 years ago had warped and cracked, and some bits and pieces had fallen off. This deterioration had provided habitat for an abundance of things that sting and other things that go bump in the night. It had gotten so bad that because of an abundance of wasps and yellow-jackets, I could no longer sit on my deck except early in the morning or at dusk. Shortly after I got back from Tybee I saw a squirrel trying to effect an entry behind a piece of siding, and a little while later there was a racket in the wall. So even though I knew the work would add to the general confusion as I started preparations for my knee adventure, I went ahead. Each day brought new surprises both in terms of the intruders (dozens of old and current nests) and in terms of the wear and tear of many years, not unlike my cartilage. So we added new insulation to the renewal list. I had chosen paint colors more muted than the originals, although in the same general palette. The total effect is calm, neat and beautiful, and I can enjoy my deck again.

Last Saturday, Tammy and I went to a shower for my granddaughter Maya whose baby is due at the end of July. She had gone to college in Asheville and still has a number of friends there. My daughter Melissa flew into Charlotte, and she and Maya drove together to Asheville. Most of those in attendance are mothers, and there was the usual chatter about birthing experiences, stories of babies and sleepless nights, and tips on nursing and car seats. As the Great-Grandmother to be, I mostly watched and listened and reveled not only in the Dreyer generational picture the gathering presented, but also in the wonderful renewal of women celebrating the forthcoming birth and helping Maya prepare for the new member of her family.

Then there is the annual renewal of spring that still has a few days to go and has been especially lush this year. On this week’s beauty menu are the beginnings of the native rhododendron show, the remarkably upright and proper bloom stalks of the yucca plants, the oak leaf hydrangeas and the profusion of bright-colored daylilies. With all the heat and plenty of water, the summer flowers arrived early and my Knockout roses are blooming abundantly.

Some things renew themselves on a regular schedule so as we await the summer solstice, we can take a nighttime walk by the light of the nearly full moon. Sunday night Nigel and I walked in a moon shower with bright light in the sky and soft rain at the same time. Then with my spirit nurtured, I went inside and gratefully crawled into bed for the nightly renewal that comes through the gift of sleep.

Tuesday, June 7, 2011

Daily Walk: No Big Deal Until You Can't

My earliest memory is of taking a walk. I was three and a half. It was summertime and maybe it had rained. For whatever reason, my memory begins with my older brother Don saying, “Nonny, put your boots on, we’re going for a walk.” The boots he referred to were rubber, the kind that always had a little dirt in the bottom and made your feet stinky. My brother lined up the four Cook siblings: Don (15), Dorothy (13), David (6) and Donna Jean (3). Don was very bossy and told each person where to be in the line and how far apart we should be. It was a march in the woods, he told us. He carried a flag and was the lookout as we crossed Tyson Avenue, a brick street with trolley tracks down the middle. I don’t remember much about the march but I have vivid memory of my feet in the gritty boots and walking along directly behind my very tall brother.

My family didn’t have a car when I was growing up and little extra money for public transportation;  if we wanted to go somewhere, we walked. When I was ten, I was given a bike so I used that for longer distances, but walking was always my preference. After high school, I went to DePauw University, a sprawling campus covered with maple trees that turned gold in the fall; snow and ice were common in winter. Regardless of the weather, the only way to get around was to walk because students were not allowed to have cars.

Fortunately, I married a man who felt the same way about walking as I did. We took an evening walk as many nights as we could, pushing babies in a carriage or a stroller when they were little. Later, when we began traveling, Bill and I seldom used buses or cabs and walked whenever it was feasible. As he was less able to cover long distances, we strolled and rested on benches or stopped for tea. In his last year, he could only walk for five to ten minutes and moved very slowly. I began taking an additional walk alone while he took a nap. After he died, my walks were curtailed by my own illness, but as soon as I could, I began the ritual of a daily mile with my dog Nigel. I have several routes either close to home or along the river in nearby Spruce Pine or in Burnsville—our county seat. One of the main reasons I go to Tybee Island each winter is so that my walking will not be interrupted by cold weather.

Nowadays, I don’t walk merely for pleasure or meditation, it is also my prescription for health. I have an assortment of physical issues that I have to manage and the doctor’s recommendation for all of them is the daily mile. In the spring, I bask in the beauty of each new round of blossoms from the early hush of white on sorbus trees through the trillium, dogwood, and laurel to the glory of the native rhododendrons with many others in between. Come summer I have to walk at dawn or dusk to avoid the heat of the day, but either one is beautiful and I see more wildlife, an occasional sunrise and frequently an early evening star. In the fall my road is soon covered with leaves or pine needles and there are golden rod, milkweed and other late blooming wild flowers.

For the past four years I have had intermittent problems with my left knee and have used a Leki walking stick for both support and balance, There has been some discomfort and occasional aching, but it wasn’t an issue until this past March when both severe pain and dysfunction slowed me down and eventually limited me to a slow half mile. “You need a knee replacement,” my doctor told me bluntly. The x-rays confirmed that there was indeed good reason why it hurt, and the surgeon concurred that now is the time. So very soon I’ll be in the hospital for surgery and then working hard with physical therapists to assure that I’ll soon be back to my daily walk. But before that I hope I will still have a few more early mornings like the one I had yesterday.

Nigel couldn't contain his joy and huffed at me to go for a walk before the sun rose, and the sky was just beginning to lighten. I resisted for a few minutes but he was twitching at the door and, thinking he might have a full bladder, I got up, put on my socks, shoes, glasses and bathrobe, and out we went. Ever since pain has been limiting my walking, I do try to give my first energy and almost pain-free steps to that morning meditation/exercise/joy time, but usually not before 6:00 AM.

There was no urgency after all. Nigel’s bladder held to the first marking spot, and he carefully measured out his available urine to mark all the usual places down Grindstaff Road. His little body twinkled and danced, and although I was holding the end of the leash, we walked our separate walks. He never looked at me, but went about his morning routine with great enthusiasm. I have a mark of my own which is a tree one-fourth of a mile from my house and I turn there since a half-mile is the most I can do. Nigel knows the spot and if he gets there ahead of me, he waits and we cross the road together and start back towards home. The return up the hill is consumed by his careful examination of all of the smells on this side of the road, and he sometimes sniffs his way along the meandering route of some unknown animal. I let him off the leash as soon as we turn in our driveway, and he runs at flying speed to the door, knowing that breakfast will soon appear in his dish. That’s what they call a dog’s life.

There will be a post on this Blog every week as usual during my surgery and recovery, but I may have a guest or two helping me out, so keep dropping by.