09:15 – Barbara’s recovery continues. She’s doing better than anyone could have expected. The nurse made her final visit yesterday, and said that the incision had healed completely. Now it’s mainly a matter of Barbara continuing her exercises to rebuild strength and mobility in her knee. She’s getting along fine with her cane, and has pretty full mobility inside the house and out in the yard. She’s not doing stairs yet, but I suspect she’ll begin doing that before long. We went to the grocery store yesterday, and she was able to cruise up and down the aisles picking out items.
I’m still working hard on the biology book, including a lot of re-write to take into account the change from monochrome images to full-color. The fact that the book is now full-color means that it’ll be a lot more illustrated than it would have been, because I can now use images where it would have made no sense to do before. For example, when we’re doing Gram staining, the original draft had no image because showing a monochrome image of Gram+ and Gram- bacteria was useless. (“The violet-stained Gram+ bacteria are visible in Figure 3-8 as gray, and the pink-stained Gram- bacteria as … gray.” or “The green chloroplasts are visible in Figure 4-12 as … gray dots.”)
17 Comments and discussion on "Tuesday, 18 October 2011"
My Mom had her left knee replaced when she was 70 (she’s now 86). She used a walker for a week then switched to a cane for about three weeks. After two months, she was walking around the block once a day and finally like she had no surgery. Then the worst happened at about a year later. The joint failed. She had to be ripped open again and had another joint put in. It took about a year for her to recover from that. At 86 now, she is caneless and still drives (albeit to the shops about five blocks away and that’s it). I’m 56 and hope I have her stamina at 70.
Can someone explain the significance of a bacteria being gram+ or gram-? I see it frequently in reference to bacteria, but I’ve never had it explained. So, the bacteria either does or does not stain with the dye. So, what? What does it mean?
Barbara’s progress is good news. My cousin and his wife are about the same age as you and Barbara. My cousin’s wife had both knees done at the same time. That was in July and she is getting around without the aid of anything. Before the operation, she was quite concerned about why–at her age–she would need joint replacements. But now, she does not care; she says she is almost at the point where she feels as good as a kid, again. A friend convinced her to have both done at once, instead of two separate operations. My cousin is happy she did that, as the thought of facing a second recovery period would have been depressing to her.
My wife had her hip replace in March and gets around just fine. Recovery on knees is supposed to harder than for hip which strikes me as odd. For hip they severe some large muscles and actually dislocate the joint, along with the usual drilling and grinding.
My mother and older brother both have new knees and are pleased with the results.
MrAtoZ: why did the joint fail? I thought they were fairly robust with most of the problems resolved. My wife’s joint is titanium with a ceramic overlay. Damn expensive. 33K just for the joint not counting installation.
$32K of that $33K is to cover the manufacturer’s liability.
One essential exercise for getting a knee back into shape is your basic kick motion. You should drive Barbara to one of the Occupy Wherever protests and she can kick some hippies.
$32K of that $33K is to cover the manufacturer’s liability.
You sure about that? Your estimate may be a little high. The guys in the machine shop in the building where I work would make one for $499.95 and consider themselves ripping me off.
Of course there was the hospital charge of $250.00 a day for the trapeze bar above the bed. For that cost you could hire a college graduate with a degree in ancient Roman history to help you get in and out of bed.
While Barbara was in the hospital, the nurse told her that one 325 mg aspirin was billed at $8. I think we just bought a bottle of 1,000 at Costco for less than $8, so their markup is about $7.99 per tablet.
SteveF: from what I’ve seen of those protests, they’ve been justified. People are angry at how corrupt bankers and politicians have been allowed to have their collective way.
Maybe not so robust 16 years ago. I was serving in Korea at the time and didn’t get the details of why. The reboot has been serving for 16 years without a problem.
eristicist: Agreed, they make a few good points. But the points are being lost amongst the moochers and clowns that make up the protest. Similarly, in the 1960s among other things the hippies were protesting the draft. They made a good point: conscription is a heinous perversity in a supposedly free society. But they damaged their nominal point by mooching around, avoiding work, avoiding responsibility, casting aside all aspects of society which interfered with “I just gotta be me”. Who’s going to listen to anything a dirty bum has to say, even if the bum calls himself a counterculteralist?
(NB: I’m going by reports here, as I wasn’t born when all that started.)
Bob, please warn Barbara to be careful with that cane. I’ve had occasion to use one a lot, and still must to some extent. It gave me carpal tunnel damage in the hand/wrist that bore down on the cane. Ask her to put weight on the cane to the absolute minimum necessary – use for balancing rather than weight-bearing. Please?
MrAtoZ: Yes, the technology is certainly better. My wife’s implant is supposed to be one of the better technologies and is supposed to last 25 to 30 years under normal service. About the time we went through the procedure there were all these ads on TV from lawyers about defective hip implants. Hers was from one of the companies mentioned. Turns out it was an older, cheaper model and a type that is no longer used. Her surgeon indicated hers is the latest and greatest available.
He also explained that the models in question were state of the art at the time and the issues being litigated are for issues that were unknown at the time, such as excess metal in the blood stream. He also stated that this excess metal has no known health issues. The problems with pain were because of a bad installation, or the patient abusing the joint, not the hip implant itself. It is basically nothing more than lawyers looking to get rich. I suspect that the comment about 32K being for liability was not far from the truth.
There were many charges in the hospital that I thought were outrageous. The trapeze being one item as it is really not a consumable item.
Years ago my wife had endometrosi (sp) surgery, outpatient stuff. When I got the bill there was a charge for $250.00 for video. I called and demanded the video since I was paying for it. The hospital said I could not have the video. It was for them to protect them from liability. I told them that since it was for their use, then I was not paying for the video. They removed the charge from the bill.
Since that time I have always asked for an itemized bill and scrutinized it heavily. With the computers they use in the hospital the billing is much more accurate and this last surgery there was nothing on the bill that was not available, consumed, or used.
Thanks. I just mentioned this to Barbara, and she says she’s not using it to support her weight, just to keep her from losing her balance.
A lot of my video work involves listening to doctors explain all this joint replacement stuff. There are very few people–very few–who have problems with joint replacement these days. If problems are going to develop, they usually expose themselves within 6 weeks to 6 months. In the situations I have been involved in, it is not a problem for the docs to go back in and correct whatever was the problem.
One guy had a ball that was one tiny size smaller than the socket. It was determined from all the computer records kept during the operation, that a nurse had mistakenly laid out non-matching parts. The patient was in no pain, the joint just rattled. The hospital corrected the problem with another operation a year later. The patient was inconvenienced significantly less the second time than the first. Even so, he sued for big money.
The court awarded him only lost wages for the second operation. The operation was free to him, via the hospital’s insurance to correct just such occurrences. As the “medical outcome” was the same as if they had done the operation properly in the first place, the hospital and doctors were absolved of any wrongdoing, as–except for the lost wages–the patient had been inconvenienced, but not harmed by the mistake.
There is so much good knowledge and practice taking place these days, that delay in treatment due to misdiagnosis seems about the most dangerous threat.
Cost of health care in the US has been a shocker to me, compared to Germany. Dean Baker has been saying for years that health care costs are the biggest threat to the US residents’ economic well-being. As an example, I have had to make several visits to the doctor recently, to track and adjust medication changes. Each visit was less than 20 minutes and cost US$120. In Germany, I NEVER had a doctor’s visit cost more than €20, which at the time of the worst exchange rate was US$30. At one point, I had a cut cleaned up (by a doctor, not a nurse, as would have been the case in the US), a tetanus shot in the hospital, and the total charge was €8. I was paying full freight at that time, because health insurance did not become mandatory there until a couple of years after those events.
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