Update on Betsy from Dan 11/20/2007

Tue, Nov 20, 7:45 AM

Hi guys,

Here's the current scoop on Betsy (actually as of last night -- I haven't seen her yet today).

Kelsey took her in to hosp at 5:30 AM yesterday morning for final pre-op. I got Festus and Jake going and got in there a little after 7. They took her to OR at 7:20.

She went OR to recovery at 9:40, recovery to room (Maine Medical Center, Room 614, 207-662-7724 direct) at 1 PM.

She was very aware and very comfortable as soon as she arrived at her room. She has two self-administered pain medication pumps available to her -- one is a nerve block specific to the front of her knee, and the other is dilaudid for general pain not handled by the first. As of last night, she was getting all the relief she needed from the nerve block. That lets her avoid the side effects of the general pain med.

She is on the CPM (Continuous Passive Motion) machine for several sessions a day totaling 4-6 hours. This machine continuously and gradually extends and flexes her knee for her. (Check with Melinda -- apparently she's been on one). At present, it goes from 0 degrees to 40 degrees and back. The idea is to keep new adhesions from forming inside her knee joint. It is very gentle and Betsy can even sleep while she's on it.

Dr. Murray was pretty upbeat about most things after the surgery. You may remember there were three goals:

- Remove the lactic acid screws that apparently were being rejected or otherwise not playing nice in there -- Dr. Murray got 3 of 4 out -- he said the last one didn't appear to be causing a reaction, and taking it out would have made the ACL unstable, so he left it. For the ones he did remove, he packed the resulting holes with bone graft material.

- Patch the medial retinaculum (the fibrous band on the inside of the knee that helps hold the patella in place) -- this had been weakened by the second surgery and was the cause of the left lobe of the 'hammerhead', as Kelsey so delicately named it. The patch is intended to prevent the bulging.

- Release any existing adhesions -- Dr. Murray knew that there were significant adhesions around the patella, but when he got in there he found adhesions 'at every level' - in other words, all over the place. He released all of them, and told us that he could get about 45 degrees more flexion after the surgery than before.

Now the goal is to prevent new adhesions. The CPM is one tool. Dr. Murray also implanted some plastic (I guess) film that is designed to keep adjacent tissues from adhering. And he plans early and aggressive PT. He says he is going to do anything and everything he can think of to prevent adhesions, since he says adhesions are something that Betsy's body is unusually good at producing.

The one bad thing that Dr. Murray had to say was that there is some indication of post-traumatic arthritis. It sounds like this is a wait-and-see thing at this point -- could turn out to be anywhere from nothing to significant.

The only other bad thing isn't a prognosis thing, it's more of a convenience/expectations thing: Betsy was counting on getting out this morning, but from what Dr. Murray told us, it will be more like tomorrow afternoon or even Thursday morning. She's not happy about that, and I don't blame her, but she needs to look at the long term.

All in all, I think right now we're right where we hoped to be. Betsy now will need to make it her priority to follow orders in regard to preventing new adhesions. She's pretty much in a last-chance situation, and if she decides she's going to 'play through the pain' in a way that ignores or violates her PT instructions, she may pay in a big way.

Thanks for all your encouragement and best wishes. Have a great Thanksgiving at Hidden Valley. If I know Betsy, she'll be hoping you're all having enough fun to counterbalance her temporary setback!

Dan P Barrett L.L. Bean Information Services dbarrett@llbean.com Office: 207-552-2098 Cell: 207-838-3021 Cell Text: 2078383021@mobile.mycingular.com

Wedding

Hi everyone!! I just re-discovered the BrackLog and saw that Betsy was updating it with wedding plans, so I thought I would use it to apologize because I will (sadly) not be able to make it. :-( My schedule is really full between student teaching and classes and I have a big project due the Monday after the wedding. I'm really bummed that I won't be there, but I'm sure you will all have fun!

Good luck/Congratulations Zac and Jess!!!

See you all on Thanksgiving!!

Wedding Update

Poor Zac and Jess.....a couple of set-backs last week. First, the wedding invitations got mixed up and they won't be ready in time. Therefore, they'll be making lots of calls. Just want you all to know that you are invited!

The other set-back was that the wedding ceremony location remains the same..... but, they were told last week that a reception at that spot would be too disruptive to the neighbors. The good news is that the Higgins Beach Inn was available for the reception! It is only a couple of blocks away so very convenient.

Wedding details:

• Ceremony at noon.
• I'd suggest parking at the Higgins Beach Inn and walking to the site. We will meet everyone there and give directions. There is very limited parking at Higgins Beach.
• The reception will start at 1:00. Buffet and dancing under the tent.

Rehearsal dinner details:

• CASUAL
• Cocktails at 6:00
• Lobster Bake at 7:00
• Location - Dining room at Higgins Beach Inn

Wedding planning

I don't think I like these last minute weddings! The invitations will be late (going out next week) but please plan on Saturday, September 15th at noon.

Also plan to join us for the rehearsal dinner Friday night. It will be held at the Higgins Beach Inn....probably around 6:00.

Lodging: I've only been able to secure 5 rooms on Higgins Beach. Two rooms are at The Breakers which is a bed & breakfast near the wedding site. I thought this would be good for Mom & Dad and Sally & family since they are doing the flowers. I've also secured 3 rooms at the Higgins Beach Inn (unfortunately shared bath) and I'm on the waiting list if any other rooms are cancelled. Any takers? I'll let you know if other rooms open up. Even with the shared baths, this is a nice spot and convenient to the rehearsal dinner as well as the wedding site. Other hotels near Higgins Beach are full (Black Point Inn and Inn by the Sea). There is a motel not far from us that is nice and not too expensive. It is called America's Best Value Inn.

Let me know your plans. Let's hope for a beautiful day!!!

Is Anyone There?

I thought I would try to write this in the blog as I think this is a great place to communicate.

I have two questions for everyone. First, do you think Dad should be driving? I know this is easy for me to ask from here and the implications are most impactful for Sally/Doug et al. But I just wanted to see where everyone is. I know the medical community does not support us on this. Regardless we need to ask ourselves whether this is safe from our perspective.

Second, should we be preparing Mom and Dad for moving to the "big house"? They really love they home, especially the new deck. The issue is not what is going on right now, but may happen in the future. We prepared them for this move to Springhill, should we be doing the same now?

Mom and Dad were great in Stone Harbor, so I am not raising these issues in reaction to seeing them. Simply I feel a bit disconnected from all of you on these issues.

Hope you are all there and listening!

Bart

Dad's Doctor's Appointment

Sally and I went with Dad for his doctor's appointment yesterday. We thought that it was going to be a review of his May test results. As it turned out it was an appointment for another battery of tests. Before we went in for the appointment Dad seemed very agitated; I think he was concerned about what he was going to hear. When we were told by Terri (the Phd Psycologist candidate from Eastern Michigan who is doing the testing) that Dad was actually scheduled for another 3 hours of testing Dad seemed to be both relieved and upset that he would have to spend the afternoon taking additional tests. Terri explained that the tests were different from the May tests as they focused on sequencing and recognition as opposed to memory. Because Sally and I were there Terri started Dad on the testing and spent about 20 minutes asking about our concerns about and observations of Dad. We discussed short term memory issues, how he handles crisis situations, his inablility to complete mathematical tasks that used to be very simple for him, his inability to remember people's names and our concern about his driving. Terri said in her interview with Dad that he admitted that he was very concerned that his memory was getting so bad and he was embarrassed that he could not remember names. She also observed that Dad was very good at hiding many of his issues, which was a comment made by Jane at Springhill when Sally and I met with her later. When Terri was talking with Sally and me Dad came to the door three times asking Terri again how to use the computer and take the test. Sally suspected that Dad was both confused and also concerned that we were talking about him.



We left Dad and went to Springhill and talked with Jane to set up nursing help for Stone Harbor. Jane is a wonderful person and she is taking great care of Mom and Dad. She will be setting up daily visits with a primary nurse and also a back up nurse. Jane also made some observations about Mom and Dad saying that Dad is very good about covering up his memory issues. She felt Mom mentally was doing better than Dad. She also told us that we would be observing Mom and Dad becoming more reclusive and avoiding large groups of people. She warned that family vacations are often when this becomes more apparent as it is an unfamiliar environment. However the fact that Mom and Dad are going back to the same house in Stone Harbor will hopefully be a mitigating factor.



Sally and I then went to see Mom who was reading on their new deck. She seems to be doing very well although she says her legs are still weak. She is now taking her cane whenever she goes out.



We picked up Dad at about 5:00. He was tired but in a good mood. The tests were not as bad as the ones he took in May; however he said many times he was not able to complete the test in the allotted time. Terri finishes her internship at Hamot at the end of July so we made an appointment to discuss the test results on Friday, July 27th at 1:00pm. This appointment should not take more than an hour. Terri feels that she should get through her review in about 40 minutes.



After the appointment Mom, Dad, Sally and I had a very relaxing dinner at the Yacht Club. Mom, Dad and I then went to see the Saybrook house and the new aquatic center at Kahkwa. Their old house looks completely different with a three car garage, a new concrete driveway and a hot tub off of the master bedroom.



My overall observations are that Mom is doing really well despite the weakness in her legs. Dad physically looks pretty good; however his short term memory issues are more noticeable. At dinner he asked me the same question several times within a couple minutes.



One last item...Sally has told Mom and Dad that a two bedroom apartment with a balcony overlooking the fountain, potentially with a view of the lake on a clear day is opening up. We decided it is best to soft sell it and neither Mom or Dad have rejected it outright.



Both Mom and Dad are looking forward to Stone Harbor. Melinda and I will take care of getting them to Stone Harbor and setting up and stocking both houses.

Stone Harbor

It now looks like Maddie and Myles will be going to the shore from August 5th - 8th. It is unclear whether I will be there with them. Rebecca, Jacob and I are still shooting for the first week. Any new news on Mom and Dad? Is anyone else going to FL for Aunt Muriel's Memorial Service other than Chuck, Mom and Dad?