Wednesday, July 9, 2008

Joint Effort on Knee Replacement Surgery

Richard Scholz had always been an active man with lots of interests. He played baseball at the squadron-level while in the Air Force, traveled all over the world and was a gourmet cook.

But at 66 years old, he was slowing down considerably and realized he was becoming old before his time. It was his knees. For the last four years, they hurt nearly all the time, making it painful to walk.

While on the cruises he liked to take, he was forced to forego activities and day excursions off the ship. He found it difficult to get around; he even had trouble shopping for ingredients for the gourmet meals he liked to prepare.

His immobility led to weight gain and other health risks.

In November of 2007, Richard Scholz took the first step toward recapturing his active lifestyle.

Richard had been on a cruise and had talked to folks who had knee replacements. It was obvious to Richard that they could participate in activities he couldn’t. Their only regret, they told him, was waiting so long to have the surgery.

Orthopedist Dr. Christopher Brown determined that Richard was a good candidate for knee replacement. “Dr. Brown said there was no cartilage left. It was all bone.”

Since then, Richard has been moving rapidly ahead toward his new life. Before undergoing surgery in November, Richard attended a one-day joint class where a nurse, a physical therapist, an occupational therapist and a pharmacist explained what he should do to prepare for surgery, and what to expect afterward. The pharmacist talked about pain management; the therapists discussed important practices that would reduce the risk of pneumonia and deep vein thrombosis – always a risk with surgery.

For those in the class with care partners present, the presenters talked about ways the partners could help before and after surgery. As a widower without family nearby, Richard was prepared to cope without a care partner. He was assured that nurses and therapists would be there to help him every step of the way.

The surgery on Richard’s left knee went well, and the occupational and physical therapists arrived the next morning to evaluate his condition. He was out of bed and putting light pressure on the knee that day. For four days, he received therapy at Fauquier Hospital twice a day.

Upon being moved the few hundred yards to Fauquier Health System’s Warrenton Overlook Health and Rehabilitation Center, Richard’s therapy sessions intensified. For years, Overlook has provided short-term rehabilitation care, in addition to its 24-hour nursing care. Richard was at Overlook for three weeks, and spent some of his therapy time in the aquatherapy pool.

He smiled wistfully, “I loved that pool. It was lovely and warm in there.

“When I came out of the pool after an hour, it felt like I had doubled my weight, my legs were so tired. I found the aqua therapists to be highly trained in their field of expertise, friendly and considerate. They provided one-on-one guidance and evaluated my progress daily. They adapted my exercise routines to my progress, and I started showing improvements in strength, reduction in pain and better mobility.”

Afternoons at Overlook were spent at the in-house physical therapy gym, building up the left knee and the muscles around it. “Overlook was a great transition,” Richard said.

Warrenton Overlook was recently recognized by the Commission on Accreditation of Rehabilitation Facilities with three-year accreditations for its inpatient rehabilitation services and for its person-centered long term care. Richard saw up close and personal why Overlook was awarded these hard-to-achieve designations.

He enthused, “They were wonderful to me. If I wanted apple juice at 2 in the morning, I got it. Whatever I needed, they were there.”

He added, “Before I could be discharged, the occupational therapists had to make sure I was going to be able to take care of myself. They took me to the kitchen and asked me to make myself some cocoa. They handed me a packet of cocoa mix and told me to fill a cup with water, mix in the packet and put it in the microwave. I looked at them and said, ‘That’s not cocoa.’ ”

Before leaving Overlook, Richard showed the staff there how to make cocoa, and another thing or two about cooking, as well. “I gave them $100 and sent them to Giant to buy scallops, shrimp, garlic and penne. I told them, ‘Buy these ingredients and I’ll make you a meal.’

“I made a big pot, and it was gone in ten minutes.”

After the three weeks at Overlook, Richard was able to go home and take care of himself. “I was able to drive myself home,” he said. “That had worried me.”

Richard used a walker at home for a short time after leaving Overlook, then gave it up for a cane. “The toughest part was changing the litter pan for my cats. I had trouble with that for a while.” But through continued therapy sessions, he worked at building up his strength.

On March 10, Richard underwent surgery on his right knee. “It seemed to go better because I was prepared for the routine. Again, I elected to go to Overlook for rehab and participated in aqua and gym therapy.”

Recovery time was shorter the second time around. Therapy at the Medical Office Building followed his rehabilitation at Overlook.

Richard recently has joined the LIFE Center, Fauquier Health System’s medically based fitness facility located on Holiday Court, a few minutes from the hospital.

Richard continues to earn the affection of his therapists through their stomachs. “They fell in love with me. I made them a Dutch Apple Cake that is wonderful, and a black forest cherry cake. Today I made sticky buns.”

Richard said that he feels there is a direct correlation between his surgery and his “new way of looking at life. My knees are fully functional, I can move around, and I feel more awake and energetic. I feel great!

“I used to be sitting all the time because of the pain in my knees. I didn’t have the energy to boil an egg, now I’m stripping wallpaper. I can go up and down steps and not be out of breath or in pain.”

Like those he met on the cruise months before, Richard said, “My only regret is that I waited so long to have the surgery.”

Richard has already lost 20 pounds with the added exercise he’s been doing, and has adjusted his gourmet cooking style to include healthy recipes. He claims he’s still got about 50 or 60 pounds to lose. With the help of the staff at the LIFE Center – and his own determination — Richard is certain he’ll reach his goal. He’s looking forward to spending some more active time with his sons and their families – five grandchildren in all.

He’s planning a trip in July to London and will visit Finland, Russia and Copenhagen. “I want to be back to 100 percent. I want to be able to participate in all activities – dancing, contests, walking tours. I still walk a little too slow now, but come July, I know I’ll be ready.”

Last leg of the journey
A visit to the Fauquier Health System’s LIFE Center on July 1 found Richard pedaling a stationary bike, surrounded by other exercisers on treadmills, rowing machines and bikes. “I’ve got eight minutes left,” he said with a smile. “Then I’ll do my strength training.”

How’s it going since finishing up with rehab sessions?

“Great. I’m coming every morning and I always feel better after my workout. Mondays, Wednesdays and Fridays I do strength training (on the circuit machines around the perimeter of the floor) and on Tuesdays, Thursdays and Saturdays I do cardio (using the various aerobic machines). My knees feel great. I’m eating like a bear. My weight is staying the same, but I am losing inches.”

The sweat is visible on Richard’s face, but his voice is steady and he’s not out of breath. “I’m up to level five,” he said, looking down at the bicycle’s control panel.

Richard’s goal is still to be in top shape for his trip on July 24, and he’s on course. In addition to LIFE Center workouts, he’s doing water workouts at the aquatherapy pool at Overlook, included with a LIFE Center membership.

“Five minutes left…. I like this bike, and that machine over there that concentrates on the arms. I don’t like the treadmill, though. Too boring.”

Richard has an exercise bike at home. Why travel to the LIFE Center to work out?

“My cats sleep on my bike at home. I never use it. When I’m here, in this environment, I don’t give up.” He looked around at the ever-present instructors on the floor. “Too many witnesses,” he said with a wry smile.

Since his initial appointment at the LIFE Center, when rehab technician John Ferguson explained the equipment and made suggestions about a workout, Richard hasn’t needed much assistance. He’s got a routine and it works for him.

“Three minutes left.”

His voice is still strong, but Richard’s smile is getting broader as he pedals. “I really feel great,” he said again.

Richard said that he is going to make an appointment with the LIFE Center’s dietitian, Aren Dodge. “I eat all right, but I really love ice cream and donuts.” He laughed. “I do need to make that appointment.”

Richard felt the tension in the bike go slack and stood up. “All done. Today’s a strength day, so I’ve got to do my circuit now.”

Richard has come a long way since he first considered knee surgery. But he doesn’t like to look back on those days of pain and inactivity. For Richard, it’s all about the adventure ahead.

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