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Monday, May 30, 2016

Let's Tile the Back Patio...

This house was pretty much move-in ready when we got here.  In other words, there was little to nothing that we really needed to do.  Oh sure, we had to create The Island with the fire pit, but for the most part, we could have just moved in and been completely happy.

And then we went to Floor and Decor.

Last weekend, along with the help of our son-in-law, Tyler the Tiler (our new name for him), we knocked out the patio, laying the tile on Saturday, then just grouting and cleaning up on Sunday.  My knees exclude me from the hard work of actually laying the tile, but I did my part by cutting the tile and handing the other two each piece.  All In all, great team work.
This was the starting point.  You'll notice that our house has Hardie siding on the back (the other three sides are brick), so we wanted to get a tile that would match well with the color.  I think it worked out.
We found the center lines and determined where we would need to make cuts, and from there, it was just a matter of getting started.  Our tiles are porcelain with a slight texture to the surface in case it gets wet so we can avoid somebody slipping.  We bought the 18" squares just becaseu that's what we have inside. It also made the job go much quicker. 
Half way done.  We purposely did one side first just because we wanted to keep the walk way to the back door open as long as possible.  Yea, call us lazy, but it worked.
Tyler makes sure the edges are perfect.  We bought a matching plastic edge that goes under the outside tiles so it looks clean and professional when looking at it from the yard.  It worked out very nicely.

On Sunday we got to work with the grout,  The color we chose matches the fake grout on the tile.  We got started early but really had to race before the sun came out to keep our bucket of grout from drying up.



In the end, the job came out great and though we were all exhausted, it was a great project for us.  And no, I'm afraid we won't be hiring out!

Wednesday, May 4, 2016

Part One: The San Antonio Weekend...

Over the last several years, Eva and I have tried to take a small road trip as sort of a break and to celebrate our anniversary.  This year, we had planned a small excursion to Houston and Galveston, but in light of the floods over the last several weeks, we decided to stick a little closer to home.  And from the point of view of my recovering knee, I'm glad we did.

We have always enjoyed downtown San Antonio and it doesn't take much to convince us to get a night or two in a hotel downtown.  At the last minute, after changing reservations at least three times, we opted for our first stay at The Emily Morgan, an historic hotel overlooking the grounds of The Alamo.

If you've been to San Antonio or scene images on TV, you've seen the Emily Morgan, even if it wasn't obvious.  It is a tall thin looking high-rise (Thirteen floors in San Antonio is a high rise, for sure) that is shaped like a V, making a wedge between Avenue E and East Houston.  If you imagine an overhead view of The Alamo (Google is your friend), where you are facing the front, You have The Menger on your right, The Crockett behind and The Emily Morgan to the left. 

I mentioned changing reservations several times because at first, I had this idea that we would want to be on the Riverwalk itself.  But after talking about what we had planned, the location closer to the Alamo worked best.  I'll post separate entries for each, but our agenda included a dinner at Morton's Steakhouse (which is located behind the Menger and next door to The Crockett), some time at Pat O'Brien's piano bar (across the street from The Alamo), and a visit to a few museums (The McNay in Alamo Heights and The Dolph Briscoe downtown). The Riverwalk, a place we love to visit, took a backseat this weekend primarily due to my knee situation.

So just a few thoughts on our hotel.  I think when you choose to go the historic route, you risk your room being a little too antique.  I think that is my complaint with The Menger.  We've stayed there numerous times and we just decided that for the money, the rooms were not comfortable enough.  Both the Crockett and Emily Morgan have figured out that people want to see all the historic stuff in the lobby, but prefer modern amenities like new sinks, new showers, and toilets that can flush a dozen golf balls, if the need arise.
Our room was a double queen suite. Apparently, this was an upgrade from the King I had originally reserved. It was clean, spacious, and ins spite of the smaller bed, it was comfortable with lots of pillows.
The bathroom was fantastic and looked fairly recently remodeled.
On the second floor, the Emily Morgan has a fitness center and pool. They did not have the jacuzzi open but we still took our drinks down and enjoyed sitting outside for a while. We didn't eat in Oro, the restaurant inside the hotel, but we did stop by for a drink and to watch the end of a Spurs game. The atmosphere was friendly and we chatted with a couple from Houston taking a break from the floods. Overall, I'd say we enjoyed the Emily Morgan for the comfort, location and friendliness of the people we encountered. A bit more expensive than your local La Quinta or staying at a place away from the main tourist area, but for this particular visit, well worth the cost. As a final note before moving on to some of the attractions, I just want to say that San Antonio really gives it to tourists, not in a good way, in the form of taxes. When you figure into the cost of your stay, between the hotel/motel taxes, if you rent a cab, or get a car rental, and all that other stuff, just do yourself a favor and automatically add $100 to your bill. In fairness, the city bends over backwards trying to accommodate tourism, attract conventions and keep the place clean and free of urine soaked sidewalks. My concern though is, it almost seems like many people watching a budget for their vacation might consider a day trip to San Antonio versus staying the night. Who knows?

Wednesday, April 27, 2016

Step Five: Pee in a Bottle...

I hope if the last part left you a little nauseous, you are feeling better.

Following my little incident with the low heart rate (reported in Part Three), I was resting comfortably just waiting to get moved to a room for my overnight stay at BAMC.  At this point, I still had not seen Eva, though she had received a full report from Dr V. and his team.  Apparently, there was some sort of back-up in the recovery ward they were sending me to.

When I finally made it to my room, I was hooked up to the usual lines and given a quick introduction to the nurse and tech.  The tech brought in a spiffy ice chest with tubes leading to a wrap around bag to put my knee on ice.  This is used to reduce the massive swelling.  In fact, the last time my body experienced this much swelling was when I got my vasectomy.  TMI?  Probably so.

Someone handed me a menu card with vague instructions on ordering food and my daughter quickly called in a sandwich from the dining facility.  At this point, I just wanted to sleep so the fact that the nursing staff was going through a shift change didn't really register with me.  The result was, the outgoing staff didn't really give a good turnover to the incoming staff, and the incoming staff did not realize I had not had any pain meds since leaving post-op.  It also meant that since I got into my room after normal duty hours, I had not seen the people from Physical Therapy.  Their goal is to get you up, show you how to use the walker and safely get to the restroom when needed.

If it sounds like I'm about to complain, please know I'm just trying to give some information to any readers who may find themselves in a similar situation.

While we were in pre-op waiting, one of Eva's friends from school who happens to be a nurse at BAMC, stopped in to say hello.  She told me that during recovery, when they asked me what my pain level was (they use a zero to ten scale), to always say at least five or six.  This way, they are always ready to administer my next dosage of drugs.  She told me that for the first 24 hours, just stay as medicated as possible so I could sleep through the pain. I think this was fantastic advice.

I got my last dosage of pain meds right before I left the post-op ward at around 5:30 in the afternoon and in spite of the fact that I was reporting my pain level as six or seven or eight, I didn't get my next real pain meds until close to midnight.  This was a result of shift change and the fact that I was too polite to complain.
Then, at some point I realized that I had not pee'd since around 7AM. I started to remove the ice bandage from my knee but then realized that I had an IV and no walker.  I was able to get the attention of one of the techs and told him that I needed to pee.  He went and got the nurse and she asked me where my walker was.  I told her I didn't have one.  She then asked me if I had seen Physical Therapy and I explained that I got into the room after hours.  "Oh, then you can't go to the bathroom until you see physical therapy in the morning. Didn't anyone give you a bottle?"

I honestly thought she was kidding, but sure enough, she came back a minute later with a large plastic pee bottle.  She handed that to me, then put the ice pack back on my knee and finally fixed my blanket situation.  Did I mention that pretty much everyone in BAMC had seen my man-parts hanging out in the breeze?

I will tell you that the overnight nurse I had was good.  She recognized that I was in pain and started loading me up in order to try to minimize the discomfort.  She would explain what each medication was and give me the option of jumping right to the Morphine drip.  Though the idea sounds comforting, I decided that I was not going to go the morphine route unless the pain was simply unbearable.

Overnight, sleep was sporadic at best and downright uncomfortable.  When morning finally came my main focus was just getting discharged and taking my chances at being home.  If you have to be miserable, be miserable in your own king size bed.

They brought me in a recliner type chair so I wouldn't have to lay in bed all day.  My first move, getting from the bed to the recliner was actually not that eventful.  I thought that the smart thing to do would be to put my weight on my good leg and simply scoot myself over to the chair.  In reality, with all the wires and stuff, I ended up just standing and placing weight gingerly on my new knee.  There was no excruciating pain like I expected and once seated, I was pretty happy.
I got a visit from the a functional therapy lady who brought me a little grabbing stick.  Think of a grabber like you might use for picking up trash along the highway if you were on probation or a high school kid doing service hours.  Using this picker-upper-grabby thing, she showed me how to put on pants, how to untie shoes, how to scratch my back and a whole host of other tricks that, in all honesty I never really used.
She also had a spiffy device used for putting on socks.  The people who invent these gadgets are so smart.  I also never actually used that one either.
The final surprise she had for me was a leg mover.  It was a long strap that looked like a dog leash but was fairly stiff with loops on either end.  The point of this device is to be able to place the foot in the bottom loop, then lift your leg up, soy for instance when you were climbing into bed.  I think even people who haven't had knee surgery could find use for this one.

Next up, a man from the medical supply company came in to provide me with a walker and a potty seat.  The potty seat is what they call a three-in-one.  You can either place it over the toilet and sit on it o you don't have to squat down as far, or you can use the handy bucket and just poop right into there, then have some able-bodied person (think: your wife) empty your poop for you (not likely). And the third thing it was for was to act as a seat for in the shower.

I can report that I did use it the first time I took a shower, just because Eva insisted, but I never once used it for the other two purposes.  I'm sure these things are useful, but, no thanks.

After breakfast the guys from Physical Therapy came around.  The first attempt at getting me to stand up and use the walker came to a sudden halt when I nearly passed out due to nausea and dizziness.  A nurse gave me some Zofran to calm my stomach and in about twenty minutes I was up on the walker and making first trip around the ward.  I also took a quick detour to the bathroom where I was able to demonstrate that I could pee without dribbling all over a plastic cup.

The goal was to have me do several laps around the ward using the walker and show that I could get in and out of bed, in and out of a chair and get into the car that would take me home.  I also need to get cleared by the surgeon and get all my meds squared away.  I don't remember when I actually was released but the long wait was getting the meds ordered and getting someone from the ward to go down and get them for me.  Once again, a shift change was involved and I think the oncoming shift finally got tired of me asking for a status.

I know a lot of this sounds whiny and it is. The truth is, this was major surgery but it was an optional surgery.  When you are at BAMC, it is really hard to complain about how bad you think you have it when you need only look in any direction and see wounded warriors of every description.  Young guys with missing ears, gals with missing limbs.  I'm sure they'd be amused that my knees hurt from running too much.   In the grand scheme of things, I had to pee in a bottle, wait for some meds, and watch a little TV connected to my bed.  We should all be so lucky.

Next time I'll tell you about my home therapy and my amazingly fast recovery.

Squirrel Nuts: Not Just for Breakfast Anymore...

We were a little worried that we might lose touch with all the nature we left in our old home when we moved back into the city.  Thankfully, we've found that no matter where you go, Mother Nature offers evidence of her presence.
Just yesterday, we saw this little act of kindness.  Mr. Squirrel had gotten tired during his journey across the street and his friend, Miss Buzzard gave him a helpful drag the rest of the way.

Que Cute!

Tuesday, April 26, 2016

Step Four: Avert Your Eyes if You're Squeamish...

As warned, this is the part where I show you the pictures.  Oh, don't be a baby.  This is real life right here.  Just think, if you found yourself to be a member of The Donner Party, this would be a nice juicy steak.
As a recap, this was the original x-ray where Dr. V. showed me just how bad things were.

The day following surgery when he and Dr. W., his resident came down to see how I was, he showed me these pictures.  My wife had already requested copies, so I present them for your viewing.

These show the actual procedure in progress.  I'm not smart enough to figure what is what but you can see that they have cut open the knee and and are monkeying around with it.  I think it is cool how they use a tool to spread it all open.  What may not be apparent in the picture is that my skin is covered in a film of sort.  One of the big things they are trying to protect against is the spread of germs.  Everything is super sterile (though I'm pretty sure my man-nuggets were flapping around unprotected).
This is the hardware pretty much installed.  On the top part, you see the new metal or Titanium knee.  That nylon part makes it all work smoothly when I bend it.  You can also understand why my knee is was so swollen after the fact.

For those into specifics, the system used is the Stryker Triathlon knee.  And no, there is no expectation that I'll be running in a triathlon any time ever.

Monday, April 25, 2016

Step Three: Don't Follow the Light...

If you haven't read parts one and two, you might want to go back by clicking here.

Okay, no more trickery; this is the part where I see the brightness people often report during near-death experiences.  

They rolled me from the operating room to the post-op recovery area.  I knew at the time that I was still very much enjoying the affects of the night-night juice they gave me for sedation.  Though I was conscious, I felt like I had smoked a pound of weed (if that's what that feels like).  I've seen all these videos on YouTube of people saying and doing silly things after having their wisdom teeth removed, and it was my intent not to do anything stupid.

I was placed in a bed in post-op with my own nurse checking my vitals, keeping me company and chit-chatting as best I could.  I don't want to get too specific, but on the other side of the curtain was a woman I had seen in pre-op.  She was in the room next to me and what I figured out was that she had severe personality issues.  As my nurse would take my blood pressure and such, we would hear an outburst from this young lady, wanting more drugs, wanting to see the doctor, wanting her husband, and generally being crazy.

Some of the things she said were more than outlandish and to be honest, I was impressed with how the staff on the other side of the curtain tried to calm her down and stay positive.  There were several times when she said something extremely crazy and the nurse and I would look at each other and try to suppress our giggles.  She whispered to me, "This is so unprofessional of me, I shouldn't laugh."

"A new knee and free entertainment.  I love this place." We both laughed but admonished ourselves for such insensitivity.

I don't know how long I had been there but it probably wasn't long when I started to feel a little nauseous.  I said to my nurse, "I promise, I won't throw-up on you, but I seriously need to puke."

She quickly handed me a vomit bag and told me she could give me something for nausea.  She then asked me if I was feeling any dizziness.  

It hit about that quick.  I told her, "Yeah.  I'm about to pass out in Three, two, one..."

I'm not sure if I actually passed out or not, but the next thing I knew, there were about ten people standing around me and the commander I had seen before was yelling for someone to get the anesthesiologist.  This tall, very attractive nurse had come over and was holding my hand.  She looked like Callie from "Grey's Anatomy" and she had these big shiny bright teeth.  She was stroking my hand and telling me I was okay.

I know for a moment I saw the so-called bright light but in reality, I think I was staring at her teeth.  During my moments of bliss the anesthesiologist gave me something to reverse the problem and as quick as the crowd of people were standing around me, mostly all of them moved off to other patients.  The commander directed the anesthesiologist to stay with me until he knew I was okay.  The conversation was not pleasant at all and it was obvious that someone had screwed up somewhere.

In the mean time, the nurse on my left was explaining to me that they had given me too much Epidural and that it had gone above my waist and up to the level of my heart.  My pulse rate had dropped to 40 BPM, and apparently that can cause you to pass out.  The nurse on my right (Callie as our family now calls her) continued to hold my hand and smile, though by this point, I realized that I wasn't actually going to die, but I also didn't bother to inform her of this.  

My daughter has told me that any time an older guy prefaces a statement with "I don't mean to be creepy, but...", it is a good sign that he is being creepy.  Thank goodness nobody from YouTube was around to record me, but I did tell the commander that his nurse was beautiful and she had the most beautiful smile and it was so nice of her to hold my hand while I was dying.  He just looked at me and blinked several times and then told the nurse she could go home early.  Traumatized, I suspect.

After all the excitement was over, the anesthesiologist told me that whenever I woke up on the operating table, he must have added a bit extra and as a result, that was why I had the problem.  He was very apologetic and in fact, the following day, he came to my room and asked how I was doing and apologized again.  Honestly, I don't know how serious it really was, I mean, it seems like depending on a person's weight, body type etc., it would seem like a difficult thing to calculate the right dosage.  Either way, I don't have any bad feelings about it.

I really didn't have any concept of time, but I do know that I did not get into my room in recovery until close to 6 PM.  By then, the nursing staff was going through shift change and that led to a really uncomfortable stay overnight.  I'll tell you about that in the next part.  Also, as a way of luring you back, I'll show pictures of my actual knee and the hardware that was installed.  You'll have to bring your own barf bag. 

Sunday, April 24, 2016

Step Two: Wake Up on the Operating Table...

If you haven't read part one, you probably want to click here.

We set a surgery date of the 3rd of March and that gave me about six weeks to prepare myself.  I'm one of those guys who escaped childhood without any broken bones and aside from a few minor procedures, never have experienced any major, stay the night sort of operation.  Even though, when people would ask me if I was nervous or having second thoughts, the answer was absolutely not.  To put it into some perspective, I've been in pain for years with these knees and if I had to experience even excruciating pain for a short period in order to fix things, I was welcoming the opportunity.

The wife of a co-worker who works in rehab for orthopedic patients told me the best thing I could do was to prepare myself with pre-op exercises.  This would strengthen the muscles in the areas that will be traumatized with the idea being that, once I start post-op therapy, it won't be such a shock.  This was incredible advice.  I got a copy of about six or seven different exercises that would be helpful and for most of the days leading up to the surgery, I spent about twenty minutes on them.  Not a huge investment for the positive outcome.

I know, you want to know how I almost died.  I'll get there, but I'm hoping that if anyone who is considering knee replacement surgery stumbles across this via Google, they will find the information helpful.

Up to the day before surgery, I was planning for two partial knee replacements.  The idea of doing both at the same time, though clearly a rougher go at recovery, seemed like a guarantee that I would not chicken out on doing the second knee if the first knee was a bad experience.  I was sitting at work, pretty much setting up my Out of Office messages, finishing up last minute paperwork and such.  I figured that I could be out for up to twelve weeks.  That's another thing I hadn't experienced.  I don't think I've ever taken more than a week, maybe two off at a time from work, and the idea of being out for so long was more of a concern than the surgery and recovery.

About an hour before I was leaving work, I got a call from Dr. V.  He said that he got a chance to look at the MRI I had done after our initial meeting and he concluded that both knees required full knee replacement versus partial. The only question was, which knee did I want to do first?  We talked about it and I decided that the right knee really needed to get fixed first, though in all honesty, I could have just flipped a coin because they are both so bad.

On the day of surgery, we showed up at BAMC which is also called SAMMC for San Antonio Military Medical Center.  SAMMC is really made up of BAMC and WHASC (Wilford Hall Ambulatory Surgical Center) and a host of clinics that serve the San Antonio military population.  I just thought I'd throw that in in case you wondered.
My knee waiting for pre-op.
Eva and I signed in and it wasn't even ten minutes before we were called back to the pre-op area.  The nurse handed me a gown and some socks and told me to get nekkid (well, might as well have been nekkid considering my junk was flapping in the breeze for any interested parties to see).  I got into the bed and started a fairly long waiting process since my doctor had one patient ahead of me.

While we waited, I would get visits from various technicians, doctors, the anesthesiologist, and eventually my surgical team so they could meet Eva and let her know how things would work.

There are a lot of interesting things going on with the pre-op staff as they attend to business.  A lot of it is waiting around in the central area.  All the pre-op rooms are along the outer walls with the staff stationed in the center.  They leave the curtains to each room open except for when some sensitive procedure is taking place (like when you get nekkid), so any f the staff can see into the rooms.  When they are attending to one of the patients, they sit in the center and have a little gab fest.  At one point, my nurse was teaching the other nurses how to Salsa dance.  That was entertaining, especially when the commander of the until walked in on them.  She was embarrassed, but they all got a good laugh out of it.

Eva was looking around at the other rooms noting people coming in and then leaving on their way to the OR.  At one point, she noticed a really older man across from us had his old man balls exposed for anyone to see.  Perhaps his wife could sense the exposure because she eventually covered him with a blanket, much to the appreciation of everyone involved.

For the record, I'm pretty sure medical people see more than they care to on a daily basis, but for us civilians, I think they should let us wear our underwear during these things.  I constantly felt the blanket riding up and in truth, I feel certain that everybody in BAMC has seen my old man balls, too.
My only tattoo.
Dr. V's resident came in and asked me all my identifying information, asked me which knee they were operating on and then pulled out his Sharpie and wrote on it to make sure nobody made a mistake.  I have no idea what it even says, must be some secret medical code.

Finally, the anesthesiologist came in and asked me some questions, then explained that his goal was for me to have no memory of the surgery at all.  They do an Epidural to block the feeling from the waist down, then give you some of that night-night juice to keep you conscious, but fairly knocked out.  Because I am a veteran of two colonoscopies, I'm familiar with the scenario where you close your eyes just as they start to intrude your backside then, eight seconds later, wake up to a technician wiping down the hose.  As an aside, if you ever fear the colonoscopy, I promise, the preparation is a lot worse than the actual shoving of a camera up your butt.

I was given some drugs to help reduce the pain for the Epidural, then they wheeled me off to the OR.  As soon as you get to the OR, the temperature drops to just above freezing.  I do remember the room looking very warehouse like, almost like a weird empty room that had all sort of medical equipment rolled into it.  Maybe it was just my imagination.  Aside from them telling me they were giving me the epidural, I don't recall a whole lot of pain.

The next thing I know, I woke up and I felt great.  I could hear the sound of hammering, but I could not feel it.  I looked forward and could see Dr. V banging away on my knee.  Then I looked up at the anesthesiologist and said, "This feels great."

He looked at me and asked if I could feel anything.

"No, nothing at all, but I have to tell you, this is the best sleep I've had in months."

"Well, technically, you aren't in REM sleep, but I'm sure it feels pretty good." He offered.

"It's wonderful!" I added.

At that point, our conversation was disrupted by Dr. V semi-yelling, "Hey, you wanna put this guy back to sleep?"

And then I woke up while the technicians were cleaning everything up and they were preparing to wheel me down to post-op.

Post-op is where I had my near death experience, so I'll have to explain how that happened in our next installment.  Spoiler alert:  I survived.