Remembering a Christmas Eve past

Christmas always evokes memories of my large, loud Italian family coming together to celebrate. And eat. A lot. Italians do not consume meat on Christmas Eve and every year Aunt Rose (my grandmother's sister) would invite us all to her small house on Wellington Avenue to enjoy steaming dishes of stuffed squid, stuffed peppers, cooked baccalla, eggplant parmigana, and a big bowl of baccalla salad. I never developed an appreciation for seafood, so I would instead focus on her crunchy homemade pizza and spaghetti, picking the calamari out of the latter's sauce and passing it to my cousins.

Going to Aunt Rose's house on Christmas Eve was something my family did without thinking. It's where we belonged, where there was always a place at the table--or, for the kids, a TV tray in the living room. But that year--1975--I was halfway through my six-month recovery following my first spinal surgery (for spondylolisthesis ). In addition to a body cast, I was bedridden and therefore seemed destined to miss the annual gathering at Aunt Rose's.

But my mother, the troubleshooter, would have none of that. She managed to convince my father that I should be transported--along with my hospital bed mattress--to Aunt Rose's living room floor that year. And then it was his job to make it happen. Calling upon his friends at our town's first aid squad, I was given round-trip transportation to Aunt Rose's house by ambulance that memorable year.

The ride (literally around the corner) was the first and only time I would leave the house during the first three months of my convalescence. The following month, Dr. Keim granted me permission to walk again, but that seemed a long time off. As I was carried into the cold, crisp winter night, we paused so that I could gaze upon our house, framed in multi-colored Christmas lights--something else I would have otherwise missed that Christmas.

The warmth of Aunt Rose's house was punctuated by the aroma of Italian spices, garlic, and simmering tomatoes. In the dining room, the volume of adult conversation ebbed and flowed, and often erupted into hearty laughter. Meanwhile, my cousins, seated on the well-worn furniture in the living room, formed a circle around me as I lay in the middle of the floor. As they ate from their dinner dishes, the television droned on in the background. The youngest of us, two-year-old Michael, raced between the dining and living rooms, darting under furniture and through adult legs. Occasionally he skidded to a halt long enough to rest his head next to mine. And then he was up and running again. It was just another Christmas Eve at Aunt Rose's and I was so happy that, thanks to my parents, I had not missed it.

This Christmas finds me decades older and many miles away from the extended family that made that noisy, crowded house so special. But I am blessed to be with my own family, making new memories that I hope my children will similarly cherish decades from now.

Wishing you joyous memory-making.

Merry Christmas!

Glowing

The first time it happened, I shrugged it off.

Then it happened again. And again.

Everywhere I go these days, people keep telling me the same thing:

"You're glowing."

Glowing?

Bemused, I discussed this recurring comment with a colleague that I had not seen since a few months post-hip joint replacement (who also used the G-word upon meeting me for lunch a few weeks ago).

"You're visibly not in pain anymore. People can see it in your face," she said.

Well, the joke's on me. Here I thought I was soldiering on, with no one the wiser. But in reality, everyone else had my number.

And now I'm glowing.

After one year, one month, one week and a day since my successful surgery, I'm feeling better than I ever thought I would. And if that means I'm glowing, so be it.

In the meantime, I need to reconsider the quote at the top of this blog. Apparently 'suffering' isn't as 'optional' as I once believed.

Surgeon surprise

A few weeks ago I had my final post-op visit with my shoulder surgeon. It has been four months since my rotator cuff repair and he has officially discharged me--and told me something I never knew about surgeons.

As his nurse led me back to the exam room, I noticed a sign announcing my surgeon's intent to retire later this year. I was at once glad that I'd had my surgery when I did, and sad that he won't be there if I need him in the future.

Dr. David (Fajgenbaum) has an animated personality and, as we talked about his decision to retire, it quickly became clear that he is very excited about hanging up his scalpel to spend more time with his family while he is still healthy to enjoy it. He is also looking forward to fewer sleepless nights. What the what?

He explained:

"My wife works in a hospital recovery room and when she wheels a patient out that door, that's it. She doesn't need to think about that person again. But that's not the case with surgeons. I never stop thinking about my patients and I've had many a sleepless night worrying about whether I missed something or could have done something differently. That's one thing I won't miss at all."

He stated this as if all surgeons feel as he does. Would that it were true. But I consider myself very lucky that he feels this way.

God bless you, David Fajgenbaum. May your retirement by long and healthy, and may you rest easy knowing that your patients are better--physically and otherwise--for having known you.

Erasing muscle memory

Summer is not my preferred season. I enjoy spring and fall--the seasons of transition--much more. But as I approach the first anniversary of my hip joint replacement, summer attire and activities emphasize how my quality of life has changed for the better.

It began one random day in April when I shuttled my children and their friends to the beach for the day. Like me, my son loves to hunt for shells, but in recent years an oceanside walk--indeed, walking period--had become more of an effort than I cared to exert. But as I trailed R and his friend along the shoreline, I realized that dull ache that I'd accepted for too many years was truly gone and I could easily stroll to the pier and back--and enjoy doing it!

Since then, I've been pleased to see that only my bathing suit reveals the extent of the scar on my right hip--my shorts keep the mystery alive. I can navigate the steps to our pool--and down into it--with ease and look forward to taking the dogs for a walk.

Several years ago, I was told that the prognosis for my flatback syndrome would depend on how loose I kept my hip flexors. Consequently, as my recovery has progressed, the increased flexibility of my hips has helped me reduce the angle of my flatback and alleviated much of my lower back pain.

At this point, my biggest obstacle is muscle memory. After years of accommodating the effects of severe arthritis--a tilted pelvis, tight hip flexors, and radiating back pain--I often need to remind myself to 1) keep my right heel down (out of habit, I arch my right foot so my heel is off the floor; it was the way I compensated for said-tilted pelvis); 2) stand up straight (I tend to lean forward when I'm tired); and 3) walk heel-to-toe (I still have a tendency to swing my right leg outward). Similarly, I need to be mindful of giving my upper body a break since I no longer need to pull up on banisters and chair arms, my lower body having been sufficiently strengthened to do its own work. So my focus is to retrain my muscles to return to their normal function after years of living with a deteriorating hip joint.

On a related note, I find that I occasionally need to retrain friends and family too. For example, yesterday at the beach I was offered a chaise lounge instead of a low-to-the-sand beach chair because the lounge would be easier to get up from. "No thanks!" I said. "I've got a new hip!!"

'Live' info about early-onset scoliosis and treatment: Wed., June 5

Almost two years ago, I posted about infantile--or early-onset-- scoliosis, its possible causes and treatment, including Mehta casting.

Cincinnati Children's Hospital Medical Center is hosting a live Q & A on this topic on Wed., June 5, from 7:00 to 8:00 p.m. EST. This free event will feature Dr. Peter Sturm, as well as a parent whose young son's scoliosis was treated with Mehta casting. The intent is help parents and family members understand the treatment options that are available.

For further information and to RSVP, please visit this link.

The art of negotiation in an abusive relationship

Negotiation.

It's a skill that I didn't think I had, but recently I proved myself wrong.

When presented with a financial arrangement that demanded 100% payment in advance of a purchase, I managed to talk the seller into accepting 25% down and agreeing to 10 monthly installments for the balance--interest-free! Not too shabby. So why do I feel dejected and angry? Because I was negotiating the terms of paying for use of the surgical center where shoulder surgery was scheduled.

Call me crazy, but setting up a payment plan was the last thing I wanted to think about a few weeks before my rotator cuff repair. Yet, in the U.S., we have come to expect it. When you check in with any health care provider, what is the first thing they ask for? Your insurance card and/or payment. Maybe that's why I hear Cuba Gooding Jr. yelling, "show me the money!" whenever I walk into a doctor's office.

Experts speculate about how we got to this point and who (or what) is to blame, but I agree with Wendell Potter, author of Deadly Spin. Fault can be laid squarely at the luxuriously appointed doormat of health insurance companies and, for them, it's all about the money.

So let's think about this. If the insurance companies only care about making a profit (and they do), how confident can we be that our health and well-being will take priority when making health care decisions? The sad truth is, we can't. And, to add insult to injury, our access to health care is shrinking, as costs increase, as noted in Steven Brill's comprehensive story about "Why Medical Bills are Killing Us" for Time magazine.

Caught in the crossfire of the health insurance companies' quest for greed, health care providers have been forced to "game" the system, increasing fees to net a somewhat reasonable contracted payment amount [note the difference between the "amount charged" and "allowable charge" columns on your next EOB (Explanation of Benefit payments) statement]. Recently, my family learned the hard way (via our checkbook) that the cost for an MRI can be almost 40% cheaper at a radiologist other than the one my husband's doctor referred him to. He could have gone to the less-expensive facility, but didn't think to ask. Likewise, it was almost twice as expensive to have my shoulder surgery at a hospital, versus a free-standing surgical center just down the street from said-hospital. Lesson learned!

I liken the whole debacle to an abusive, dysfunctional relationship. We know on some subconscious level that it's wrong--not to mention unhealthy--but we accept it because we don't know any other way. Except to negotiate.

Another surgery looms

For someone who enjoys relatively good health, I've had a lot of surgeries. And this month I will be going "under the knife" again, not quite six months after my hip joint replacement. This time, I will be undergoing a rotator cuff tear repair on my nondominant (left) shoulder.

The first question people ask is, "What did you do?" And how I wish I had a thrilling story to tell; one that climaxed with a dramatic injury necessitating surgery. Alas, my life is not that exciting. To illustrate just how NOT exciting my life is, here is how my doctor explained I came to have this rotator cuff tear:

"It's kind of like an old sock where, eventually, the worn-down area becomes a hole."

Old sock? Lovely.

The reality is, I've had tendonitis in my left shoulder for many years and, as my hip deteriorated--and I relied upon my upper body for balance and leverage--the pain (and the tear) have gotten worse.

Although considered "minor" when compared to hip joint replacement, I've been told that the recovery can be painful. One plus: we bought a new recliner, which is where I will be sleeping for awhile post-op.

Unlike a hip joint replacement, where the patient is urged to get up and move as soon as possible, a rotator cuff repair requires immobility to heal properly--and then physical therapy to restore range of motion and strength.

"Follow doctor's orders," those who have had this procedure tell me. Otherwise, more surgery will inevitably follow.

Point taken. After this one, my goal is to stay out of the OR for a long time.

Great resource

Happy New Year!

I've been spending a lot of time in orthopedists' offices so far this year--not for my hip or back--but for my upper extremities. More about that soon. But in the meantime, I wanted to share this website from the American Academy of Orthopaedic Surgeons. Very useful, easy-to-navigate site with lots of information. You can also search the membership directory to find a doc near you. Good stuff!