Central  South  Dakota  Medical News
The Clinical View
 by Phillip E. Hoffsten
23 June 2004

What Really Happened, Many Thank-yous and a Perplexing Question.

     I said that I would get a follow- up column written last week regarding my left total knee replacement.  Too many pain pills, but still a distracting low level pain, and the week just slipped on by.  So now the world is a little brighter, the pain is less, and I can think as straight as I normally do; so here is that follow- up column.

     By the morning of June 8, 2004, Dr. Ken Bartholomew had gleaned every piece of medical information imaginable from my medical history.  He had completed the physical examination, multiple blood tests, the exercise stress test and certified me ready for surgery.  Thank you, Dr, Bartholomew.  I was more fortunate than Larry Dietrich who went through the same pre-operative evaluation but was found to have a life threatening abnormality.  Pre-operative evaluations are a critical and life saving part of medical care.

     I dutifully got up at 5 AM and was at St. Mary’s Hospital in Pierre at 6:00 AM.  The nurses at our central South Dakota Hospitals are wonderful.  One of them is Diane Rislov, RN, who painlessly started an intravenous site, Naired the hair off of the surgical site, and scrubbed the knee.  Thank you, Diane.

     Then Greg Jung, the anesthetist came by and explained the anesthesia process.  Steve Stout, the orthopedic surgeon, came by to see if everything was a “go”.  It was a “go” and I was wheeled into the surgery suit where Greg Jung told me he was going to give me a little Versed (a sleeping medicine).  That is all I remember until later that afternoon.  Thank you, Greg.  Thank you to anyone else who helped with the surgery, but I was out and have not a clue who was there.

     I was subsequently taken to the recovery room where I was described as restless and in pain.  Jackie Neilan, RN, mercifully gave me enough sedative to put me back to sleep and stop the pain.  Thank you, Jackie.

     Then started the rehabilitation process.  The rest of the surgery day is rather a blur, but I do remember Renee Cowan, RN, being another wonderful nurse who helped take care of me.  In the hospital each patient is assigned to one particular nurse who has primary responsibility for that patient’s care.  I cannot imagine why, but apparently taking care of a doctor as a patient is a threatening assignment.  Renee was particularly concerned about dealing with pain control and she was excellent.  Thank you, Renee.

     The night of surgery and over the next two and a half days my nurses were Rhonda Marvel, RN,  Kim Dowling, RN, Noel Doerr, RN, Tammy Moran, RN, and Agnes Lord, RN.  Thank you all.  You were wonderful.  A little extra thanks is due Noel Doerr for remembering to send my urinal home with me.

     The physical therapy department at St. Mary’s Hospital is outstanding.  The day after surgery they help you get up and walk, a necessary step surprisingly well tolerated.  They have a set of exercises that reestablish straightening and bending of the knee.  They say these are important; but let me tell you; these exercises have a clear negative recreational value.  They hurt.  Very compassionately, Christine Sahr PT, Amy Hofer, PT, Janet Kahler, PT, Kylie Volmer, PTA, Nikki Schnabel, PTA, coached me thru the exercises.  Thank you all.

     Everything went as well as can be asked during my three and a half day stay at St Mary’s Hospital.  By Friday morning I could bend my knee to at least 90 degrees, get out of bed by myself, and bodily habits were reestablished.  Dr. Stout recognized that with Peggy Hoffsten, BSN, I had great nursing care awaiting me at home so he let me out.  Thank you, Dr. Stout for your excellent judgment, surgical skill, and postoperative care.

     So it is now ten days since my surgery and I am home one more week to rehabilitate the new knee.  Yes, I would do it again.  However, I have learned a new level of respect for all those who have ever had total knee arthoplasty.  It is not for sissies.

     Then comes my perplexing question.  Before my surgery more people than I can count asked me where my knee surgery was going to be done and who was going to do it.  When I said it was going to be done right here in Pierre at St Mary’s Hospital by Dr. Steve Stout, there frequently came a look of surprise.  I asked about what was surprising and invariably people said they thought I would go someplace else with the implication I would get better care someplace, anyplace else.  The truth is I choose St. Mary’s and Dr. Stout because I wanted the very best care.  And that is what I received!

     To those of you who feel out-of-town medical care is better, nothing could be further from the truth.  When you base your medical care in central South Dakota at our local clinics and hospitals, you receive competent, caring medical attention from people who live here and know you.  These caregivers are available for problem solving right here right now.  They are not 200 miles away and “not on call tonight”.  This is true of the excellent clinics provided by Rural Health Care, Inc. in the communities surrounding Pierre and by St. Mary’s Hospital.  Those who leave town for medial care are driving too far and paying too much for care that is not a particle better than what we have right here at home.