Friday, November 28, 2008

Betting With Doctors

Tommy Lasorda is supposed to have said, 'Never argue with people who buy ink by the gallon.'

To this aphorism, I would like to add my own version: 'Never bet with doctors who control your medications.'

This will be a trivial blog to you, but at the time it was very funny to me. Also it was a lesson in humility to me that doctors are right more often than they are wrong. (Ted Turner, who is about 3 days difference from my age and hence a default hero, allegedly uttered one of my favorite sayings, 'if I had some humility I would be perfect.')

Anyway, on his second day visit (Wednesday) my surgeon suggested two things: remove Freddie Foli and take the pint of blood I had previously donated which had not been used in surgery. I wasn't excited about doing either, and I explained my reasons--the first due to past urinary problems following surgery and the second due to emotional issues. I really doubted either would have much effect, and I more or less bet him they wouldn't help. But, after reminding myself which of us had the medical degree, I agreed to both.

Let's say they were both wildly successful. Instead of bladder blockage I had a good flow and no infection. The blood transfusion was like a shot of adrenalin--I got up and walked the halls, moved my bowels and in general I was ready for release the next day.

Now here is the funny part, at least to me. That evening, after my bladder was working like a Swiss watch, the nurse came in with my pills. Only the bladder pills had been doubled. Always vigilant for possible drug errors, I told her I only get one bladder pill in the evening. She said the doctor ordered the change. My immediate reaction, as I took the double dose, was that the doctor was hedging his bet to guarantee I didn't have any bladder problems!

As for the blood reintroduction, I learned he always keeps this pint in reserve to give back to his patients because past history has shown him that it does have remarkable recuperative powers. (As a student of athletics, I always knew 'blood doping' was a legitimate and undetectable way for athletes to get an edge, and now I know it really works.)

Finally, I have two quick blood donation stories. While I have often donated blood, I have never received any before this surgery. When I asked the nurse how long it would take she said four hours. I was surprised, and I told her it only took 6 minutes to donate it. Now nurses are great, but this one, bless her heart, said 6 minutes was impossible: I would have passed out in that short of time. The reason I knew it was 6 minutes was I asked the technician who took the blood what the record time was for donation. He said he had seen all the way from 4 to 15 minutes for a pint. Being competitive I joked I would try to break the record--which I missed.

The other story came 20 years ago when I had to donate 2 pints prior to hip surgery. When I asked the normal inquiry about the effect of donating 2 pints of blood so close to surgery, the technician gave the response that, quite to the contrary, the body works extra hard to make up for the lost blood, and that one actually gets a 'boost' over the next couple days. That sounded OK to me, but what came next has forever been my second favorite golf joke. Now I was giving this blood, known as an autologus draw when it is for personal use, at the Ernie Wallace Blood Bank in Midland, MI, where I live. Everything is free, no payment for your blood, and presumable no cost if you ever need blood in the future. This has been going on for a long time. I know this because about once a month the local paper publishes the names of the top donors. Lots of names and lots of blood--5, 10 even 15 gallons. Now I will help you with the math. A sign on the wall says you can donate every 56 days, so that works out to a little over 6 times or 6 pints every year. That is equivalent to 3 quarts. So a 10 gallon donor has given 40 quarts. That requires 13+ years of clockwork-like structure to your life--always in town, never sick, good veins, etc. Here's where the joke comes in. It's only natural that a number of these blood donors are golfers. With our short golf season, one tends to play in leagues to have a regularly scheduled golf time. And some golfers are very competitive. Throw in the analytical nature of our engineer-heavy population in this company town, and you have an overlapping Venn diagram just waiting to happen. Sure enough, the blood drawee said that some donors actually schedule their regular blood donation a couple days before a big golf match in their league, hoping to get that little extra 'boost' to win.


Sunday, November 23, 2008


Yesterday, Saturday, Nov 22, is our traditional Piper family Thanksgiving celebration meal. This frees both my children to have their own celebration on the 'regular' Thanksgiving day, and it certainly avoids any arguments about which parent's home you will go to each year.

Often one or more of my siblings or Judy's siblings drives up from Indiana to celebrate with us. This year's celebration was being held hostage by my recovery progress. As late as 7 days ago I announced to my son that I didn't think I would be able to make it to the dinner this year. But then the next day I changed my mind. So with 5 days lead time the Piper women huddled, plans were made, duties were assigned and we pulled it off. We had to sacrifice the Indiana families but they understood. Their places were replace by the second and only other living grandparents. Grampa Greenfelder, who recently has been through more hospital time, pain and need for caregiving than myself, was also able to make it to the dinner, which indeed made it a day for giving thanks.

Now our Thanksgiving dinner is always proceeded by family pictures--which each family then uses for Christmas cards. We have discovered the secret and ideal photo location. It is a stairs, and that allows us to squeeze 8-10 people into a small location. With some practice I managed to sit on the stairs and still keep my back straight. We even managed to find time for the youngest to have her birthday party.

With my 30 minute sitting limitation, I had to periodically disappear to the upstairs to relax my back. The 4.5 hours, 270 minutes, which we were gone from home was: 45 min car, 40 sit, 30 lay down, 10 pictures, 30 eat, 60 lay down, 10 sit, 45 ride home. This is a little more sitting than I should have taken, but I was not sore that evening or the next day. Also, I continue to be at two 500 mg Tylenol per day (one every 12 hours), which I think is very good for 27 days post-surgery.


Thursday, November 20, 2008

Beaumont, Brahms and Bills

Beaumont (Troy) is a 296 bed hospital, although it is easy as a patient to loose track of that fact when you are confined to a 12-patient wing on the fourth floor orthopaedic wing. However, four items helped me to keep my personal pain and problems in perspective with the 'big picture'.

First, Beaumont--and I suspect many other hospitals--have changed. They are incredibly quiet. No phones ringing, no nurse call bells, no clattering of carts because of carpeting and no paging of doctors--like the obnoxious PA in K-Mart--"PRICE CHECK IN AISLE 3". Also, better control of visitors has cut the background noise.

Secondly, your roommate usually has his own problems. In my 4-5 major hospital stays, I seem to have always drawn someone who was in much worse shape than I. I felt this stiffled any supportive conversation between us. On one occasion I actually had two roommates who were simply drunks, and were in the hospital to 'dry out'. And on another occasion my roommate died--fortunately after I had checked out.

That leads to my third observation. In the 3+ hospital stays I have experienced plus three more from my immediate family, we always knew we would be coming out alive. But such is not the case for many patients. Waiting rooms are a mishmash of people and emotions. While the doctors do a great job of privately speaking to family members, some individuals, particularly those with access to cell phones, seem to need to announce their problems to the world. Regardless of one's empathetic level, it is tough to hear of an expected death.

But I saved the best for last. As Judy walked around Beaumont, she would occasionally hear faint bells playing 'Brahms' Lullaby'. When she asked why, the answer was simple: 'Another baby has just been born'.

As I write this blog, 25 days post-operation, I have yet to receive any bills. We'll see how my perspective changes once the bills start rolling in.


Tuesday, November 18, 2008

Catching Up on My Progress

Larry here again.

On Nov 16th (21 days post-surgery) I created a 'recovery timeline' using an Excel spreadsheet. This will ultimately allow me to put all the events into perspective.

On Nov 11th (16 days PS), I ventured out. We stopped at a couple stores for 5 minutes while I stayed in the car. But I did walk into the Midland Community Center--my second home--where I met the 8-9 guys who play paddleball every Tuesday night. It was great for me and VERY educational for them. But that 15 to 20 minutes sure set me back for the next couple of days.

Also around Nov 11th I began listening to something other than music on my mp3 players. (When you are lying flat on your back 22 hours a day, there are not many options for things to do. I would love to have a ceiling-projected TV.)

So here is a plug for TTC, The Teaching Company. They have created educational courses for students of all levels and interests. Our local library has many of their offerings, and I have long ago adopted the habit of listening to one 30 minute lecture every day that I work out on the stationary bike or treadmill. (I'm sure books on tape would serve the same purpose for other patients.)

This ability to listen to and comprehend these somewhat boring educational tapes sends a very big signal--not only is my body healing but my brain is also back!

My 30 minutes sitting time is up.


Pain, Pills and Piper

Sorry for the missing days--we've been busy healing. Also, the writer has changed her priorities, so blogging fell to the bottom of the list.

Henceforth, the writer will likely be Larry. That means I can now sit up for almost 30 minutes at a time, and it means my typing skills are beginning to return.

Let's talk about that four letter word PAIN. First off, that is why you have the operation in the first place. But one has to get past that first few days, and the drugs of choice are Vicodin and Valium. Now the actual pharmacy cost of these two V's are dirt cheap. I left the hospital with a prescription good for about 5 days. I did stretch the Valium to 10 days, but I elected to have it renewed going into my second weekend at home. Nonie, my guardian angel nurse, suggested I would want to get off Valium first. One only has to read about Valium's side effects to understand why. Most of my pain has always been in the muscles the surgeon had to cut to get to my spine, and Valium did help that pain.

Without referring to the extensive notes that Judy has been keeping on everything that goes in and out of me, I think the Vicodin was essentially dropped after 15-16 days--in favor of Tylenol. A couple days at 1500 mg (3 pills a day) and now 1000 mg a day has brought me to 21 days following surgery. Since I was on 500 mg/day of Tylenol for nearly a year prior to surgery, I figure that is very good progress.

Now my dreams are another story! That will have to wait for another day.


Saturday, November 8, 2008


The Zen of Healing: Bone, Muscle, Mind and Attitude *

Bone healing, short of compound fractures, seem to take four weeks. The doc says keep on the cast on for six weeks (that falls under the CYA category), and you are good to go. Hell, some bone injuries aren't even casted these days.

Now my surgery, while it involved bone reconstruction, seemed to have its own recovery schedule. Dr. Roth cut some bone away from my spine--the part that was pinching the nerves, then added some donor bone and finally retrieved some of my own bone marrow (presumeably with a LONG needle. Us chemical engineers would call this bone marrow a catalyst, but I'm sure the medical community has a much more esoteric name. This 'paste' was then plastered around my vertabrae to stablize his work. No screws or other instrumentality was used--because of the strength of my bones. The healing time of this bone paste is definitely much longer--in the 'one size fits all' mentality of the medical profession, I cannot get an answer of less than 90 days.

Now muscle healing seems to be an entirely different story. Modesty prevents me from giving you specifics--let's just say that I have more muscle strength in my back than you, and likely more than anyone you know. But it was a surprise to me that between 9 and 11 days after surgery, I had zero muscle soreness. Those first 9 days, however, did cause strange reactions with the Valium.

The mind recovery did come back much faster than I expected. I have always found that loss of cognitive function (due to anesthesia) has always been the biggest and badest, side-effect of any of my surgeries.

Now attitude is up to you. The hospitals, nurses, doctors and friends can all prepare you, but ultimately how you feel about recovery is solely up to you.


* The opinions expressed here are those of the author. Of course I could be wrong.
Also, my blogging technique consists of typing the rough draft into WordPad and then cutting and pasting the result into

Friday, November 7, 2008


The cost of hospital stay has risen so astronomically that the preferred method for treatment is to get you in and out of the hospital ASAP; i.e., baby delivery used to require a five day stay, now only one day. Twenty years ago, hip replacement required 10 days, now only three.

To make up for that difference, you are under the care of nursing staff (visiting nurses, home health care nurses) approximately twice a week. They show up with all their high tech gadgets, measure your vitals and report these back to the appropriate doctors. Technically, these nurses are there for home-bound patients, so their range of services could be very wide.

These nurses are competent, pleasant and a welcome break in your day. Usually the first time you see a nurse-evaluator who determines what level of care you need, then you see a regular RN twice a week.

From a technological standpoint, these nurses are far advanced from what hospitals use. Each one carries a PDA upon which they write notes that in turn are automatically synched to all other PDAs carried by their service and any of the appropriate doctors.

Time for an editorial……In my case, the medical community are just ballistic when you take a blood thinner like coumadin. (I will expound on this at great length in the future but the bottom line is to avoid taking coumadin at all costs.)

Two final comments about HHC nurses, (1) they are programmed like robots to give you standard answers and never give you an opinion, and (2) HHC nurses and nurses in general are perhaps the greatest source of selecting good and bad medical doctors. How you get this information out of them is a real art. So take a nurse to lunch – make a nurse a friend.

Oh yes, we made a private sale of our old blue van so we will not have to juggle three vans in our garage and driveway any more.

When I sleep, Judy sleeps. Good plan.

Dictated by Larry (Attila the Hun)
To Judy the Motivator (Nag)

Thursday, November 6, 2008


This blog was originally begun to report Larry Piper's Progress in surgery and at Beaumont. Not having posted anything for the last few days means we are very busy making "progress" at home. So now this blog will be switching to progress at home. As one of Larry’s surgeons told him….”95% of successful recovery is the patient, only 5% can be attributed to the surgeon.”

He has now cut down his drugs by half (Vicodin and Valium) which means he sleeps less. The physician's orders say he can go down and up a flight of stairs once a day when he feels ready. Yesterday he went 3/4 of the way down and back up. Today his plans are to make it all the way down to his precious computers. Now let's see if I put the commode down there along with some water and maybe a PB&J sandwich, I might keep him down there for the day. :o)

His biggest challenge right now is his inability to sit for more than 15-20 minutes at a time. His limit for sitting is supposed to be 30 minutes but he hasn't made it that long yet. His concern that he would "lose his marbles" from the anesthesia hasn't really been a problem. He remembers his passwords; he just can't sit long enough to use them.

Remember the phrase from our childhood "Every day in every way, I am getting better and better." I know you all will find this a little hard to believe but he has been a very good patient, following the rules. The desire to get back to his real life is a terrific motivator.

Now if I could just figure out all the nuances of this darn blogspot, I would be one happy camper. Maybe with time and some help I will be able to add pictures where I want them, add some sidebars, make a personalized header……..oh, the list goes on. The other member of Team Piper is still not yet ready for consulting.

Coach, Nurse, Chef, Cheerleader

Monday, November 3, 2008

Random Thoughts and Updates

While Larry is sleeping, I thought I would bring you all up to date on his thoughts and progress.

Larry's sitting is confined to 15-20 minutes max (primarily due to pain) 3 times a day plus a couple more. He's still taking his pain meds full strength after 4 days at home -- vicodin and valium every 6 hours.

He is not ready to receive visitors yet. His endurance is short lived at best right now.

Things are "going in and coming out" on a regular basis -- which is good.

He thinks he is less than 5% thru the recovery process. I think it is truly amazing what the body can do in just one week.

His brain and mouth pretty much haven't ever stopped. Illustration......his latest riddle......What is 10" and white? His decompression laminectomy scar.

Today 28 staples were removed, so now he is held together by steri strips.

Judy for "The Commander"