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Tribute of a Patient

By Mary E. Adair

Were there not some astounding (to this small-town lady's mind) information in this article, it could well be considered simply a progress note on my health following the July 8 knee replacement I had. First, let me say that most people would never have waited as long as I did to seek professional help. However, having a high pain threshhold and an indomitable need to be self sufficient, I neglected that choice though my knee was locked at about a 45 degree angle from a fall suffered in August of 2002, until a second fall in December of that year. The first had forced part of the knee joint pad (miniscus) partially outside the knee joint so it could not close properly. The second fall cut that miniscus neatly letting the joint operate all be it quite irregularly, and this writer considered it to be "back in place" and all well again.

A January office call to my doctor in St. Louis, Missouri, changed my mind as he insisted I must seek an orthopedic man who would order an MRI and other necessary tests to assure me that I either required surgery or did not. That led to a family discussion with the oldest daughter insisting that Plano, her area of Texas, was renowned for joint replacements and the search for doctors there began. Having fallen herself and been to Dr. Geoffrey Glidden, an orthopedic surgeon, she arranged an appointment for me with him.

The tests revealed much of what was told above, including the fact that both knees are badly arthritic from age and over use. So much for being proud of having been fairly atheletic in my life! Riding and breaking horses, water skiing, hiking, running, square dancing and clogging, plus nearly ten years of service in an MP Battalion of the Texas State Guard are all great activities but there is unrestrained impact on knee joints.

A family physician, Dr. Louis Coates, also had to check me out before surgery which led to having a nuclear stress test. Interesting to say the least, and conducted by caring and considerate, highly skilled technicians who eventually pronounced the test normal so that plans for surgery could proceed. The Medical Center of Plano was the designated hospital for Dr. Glidden's expertise. Despite finding a new allergy (morphine which resulted in head to toe hives) surgery and hospital recovery proceeded rapidly and on the 4th day counting surgery date, I transferred to the Plano HEALTHSOUTH Rehabilitation Hospital.

HEALTHSOUTH is like another world. A 65 bed, freestanding, comprehensive rehabilitation facility, it is owned and operated by HEALTHSOUTH Corporation. They provide a complete range of therapies and services for people disabled by spinal cord injuries, head injuries, chronic pain, arthritis, cancer, amputations, orthopedic conditions, neurologic conditions, stroke and other accidents or illnesses. Their stated goal is "to restore quality to your life, and to help you realize your maximum levels of productivity, independence and mobility."

Their therapy is available seven days a week for two to four hours daily. Also daily, five to eight nursing hours per patient are performed with regular RN accessment of each patient, and not only are there MD visits, but a board certified psychiatrist is on staff, as well. Average admissions are 125 per month with a footnote stating the mortality rate is less than 1%. To reassure families with gravely ill patients, there is advanced Cardiac Life Support available each shift. The average length of stay for the patients is four to twenty days.

Greeted pleasantly upon my arrival by Dr. Mohammed Zibari, a physician since 1984, I was made to feel welcome and as though my care was extremely important to both him and the hospital. My own in-house physician, Dr. Anh Nguyen has been with Plano Rehabilitation Hospital since 1994. He is the Associate Medical Director there, and is the Program Director at HEALTHSOUTH Medical Center in Dallas. Dr. Nguyen completed his training at the University of California in Irvine and residency at UT Southwestern. He is a Clinical Assistant Professor at UT Southwestern and is the President of Metroplex Physical Medicine Rehabilitation Society. Dr. Nguyen has a special interest in Stroke and Spinal Cord Rehabilitation. I found him quite personable and capable of inspiring a bond of trust that worked both ways: patients trusted his advised treatment, and felt that he was trusting us to adhere to it completely, therefore we did so to the very best of our ability.

I could never write enough about the wonderful physical and occupational therapists! Among those who worked tirelessly with me were Corey, Celeste, and Nancy. One of the techs named Ann gained my undying respect for the many skills she possesses and the kindness exhibited while maintaining a very high degree of efficiency. Indeed, the patient is made to feel that their health and their little gains in mobility are the most important thing immaginable to the staff.

Personally, I believe the group therapy sessions of exercise and information periods, where we became friends with the other patients to the point that we all cheered on each other in our daily workouts, is rather unique. I feel that I made some lifelong friends! One could practically consider theirself a pampered guest at a spa on some days, even with (or perhaps because of) the intense physical conditioning. Though much of the work is done by all in group settings, tailoring the needs of the patient to their rate of recovery is carefully gauged by the therapists.

Additionally, each patient has their own assigned case manager who is liason with their surgeon, family, insurance company, and arranges for the most equitable solution to post care. Through the diligence of Mary Lou Bachmann, I am now enrolled for out patient services with an equally excellent day version of HEALTHSOUTH therapy for my "graduate course" so to speak.

On my planned day of release, I awoke around 4 a.m. with a poem ringing in my thoughts. Grabbing a sheet of paper and my crossword pencil, I quickly penned the words marching in my mind. When Dr. Nguyen arrived telling me I could go home, I read the poem to him with his permission. Smiling, he informed me that he had never had a poem written for him before, and my stay was now to be one year and the prescription -- to write a poem each day for him. At my "Oh, Doctor!" he grinned and said "It's ok to go today, but I do want a copy of the poem." And I promised. So here it is, Dr. Nguyen.


Pain that comes again and again
Regularly as falling rain
That beats with your pulse
From vein to vein,
That is what leads most people here
The pain that throbs within, somewhere.
We take the tests, MRI's and Xray
And are diagnosed from day to day
Then finally, armed with all the info,
The surgeon performs as best he can know.
The anestheist, Bless him, or her as the case may be
Sees us carefully through the required surgery
Pain that comes again and again
Regularly as falling rain
That beats with your pulse
From vein to vein,
But now somewhat different than before
And the doctors and nurses stream through the door.
Since we are now repaired and on the mend,
The pain subsides daily - a wonderful trend.
Then the therapists arrive with their expertise
To guide our use of new hips, new knees,
To teach those skills that equipment requires,
And tirelessly smile throughout the hours,
And retrain our muscles, ligaments, and the mind
To properly cope with any challenge we find;
To push us encouragingly 'til the upper hand we gain
Over the
Pain that comes again and again
Regularly as falling rain
That beats with your pulse
From vein to vein,
No more!

Mary E. Adair, July 22, 2003

(Dedicated to my surgeon, Dr. Geoffrey Glidden; the Doctors and staff of Medical Center of Plano; and Dr. Nguyen and staff of Plano's HEALTHSOUTH Rehabilitation Hospital.)

NOTE: See companion article "Get Well" for an interesting sidelight on HEALTHSOUTH recreations for patients.

Leo and Mary with Mike, our friend and webmaster,
doing an on-the-deck cookout at Mike's Missouri
two-story log home which overlooks Shoal Creek from atop a bluff.


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