Day 2, Island Princess Cruise December 2009

At sea

This is our first full day on the Island Princess and we are at sea heading for Aruba.


Here's another panoramic view of the atrium.

The ship is familiar -- it's identical to the Coral Princess. We sailed on the Coral Princess in April 2007 when we made our first visit to Panama. Both ships were launched in 2003. They are medium-large ships, the capacity of each is 1,970 passengers and 900 crew. The last ship we were on, the Emerald Princess, carries up to 3,100 passengers with 1,200 crew. We like the size of the Island Princess a lot -- it's big enough to have lots of features but you don't get lost on it.

For more information about the Island Princess you can read the ship's review on CruiseCritic.com.

Our Captain is Nicolo Bommarco. We have sailed with him before. He was Captain on the Grand Princess in December 2007 when we cruised the western Caribbean. Another familiar face on this cruise is Maitre d' Mario Propato, also our Maitre d' in December 2006 when we sailed out of New Orleans on the Golden Princess heading, again, for the western Caribbean.

It's Formal Night tonight. We 'forgot' to bring dress-up clothes. Hey, this is a vacation, not a business meeting. If you don't dress for dinner on the two formal nights there are plenty of places on the ship to eat. The formality is mostly at the two fancy dining rooms, the Provence and the Bordeaux. Tonight we had room service on our balcony.

Breakfast was in the Bordeaux Dining Room. There's waiter service and a very peaceful atmosphere. Lunch was in the Horizon Court Buffet. Each sea day there's a theme at the Horizon Court. Today's was sushi, beautifully made and beautifully displayed. And all you can eat. There was 'regular' buffet food as well. And all this got us through until tea in the Bordeaux Dining Room at 4:00. I never made it to the pizzeria.

First time ever on a cruise I visited the medical center. I needed to get a test to see how the blood thinner was working. Somehow I always thought that going to the ship's doctor would be complicated and involve crowds of people and long waits. Wrong. It was simple and quick. And the doctor, a young woman from South Africa -- all the medical staff are U.K. certified -- was a tall beautiful blonde with a charming personality. The medical center was state-of-the-art. And expensive, but I'm told my health insurance will cover it. We'll see.

We signed up for Internet access, both in the Internet Cafe and in the room using the laptop. We have cruised on Princess enough times now so we each get 250 minutes of Internet time free. It's a lot better than a few years ago when $50 got you 100 minutes.

Swine Flu Map (North America)

Click here for a swine flu map of North America along with the latest details of the epidemic. It's from http://www.epidemicflu.com/.

Here's a link to CDC's Swine Flu page.

The road sign image at the top is from CruiseCritic.com's swine flu update page, also worth checking out.

Hygiene on the High Seas

PLEASE NOTE: Swine flu is in the news right now, leading me to repeat this post from January 25, 2008. In addition to info about staying healthy on a cruise there are some interesting links to the Centers for Disease Control and epidemics. Back in 2008 we were worried about bird flu now it's swine flu. Go wash your hands.

When we go on cruises we do everything possible to avoid travel-related illness, like the Norwalk virus (Norovirus).

We pack Wet Ones moist wipes, Lysol spray, Purell hand sanitizer and a pump bottle of Equate, Walmart's anti-bacterial liquid hand soap, for the cabin's bathroom. In addition, we always use the hand sanitizer stations found at every eating establishment throughout the ship. And we are very careful what we eat, drink or touch when on shore excursions.

So I was pleased to run across the following links about healthy cruising from the U.S. Department of Health and Human Resources' Centers for Disease Control and Prevention (CDC).

You can read about their Vessel Sanitation Program and the results of the periodic inspections -- with scores, reports and what corrective actions were demanded.

The CDC also has a list of cruising tips to help you stay healthy on your cruise vacation. And health news and alerts for travelers in general.

If all this information about shipboard health and sanitation isn't enough for you, check out their links to the latest news on bird flu and other pandemics.

A link to my medical blog

There's a separate blog for my medical notes and the daily log of my recent knee surgery. Just click here.

I am back home and blogging again

Two weeks ago today I had surgery on my left knee -- the Total Knee Replacement. I am doing fine after four nights in the hospital followed by five more at a rehab facility. I have been home since last Saturday.

I can get around using a walker, ride in the car and do some physical therapy. And I rest a lot. Because there was also some ligament repair necessary I am wearing a rather large leg brace for the next six weeks or so.

Despite being addled by drugs most of the time, I managed to keep a daily journal of this medical adventure. I will start posting it soon.

The Pre-Op Procedures

Last Friday I arrived at Sacred Heart Health System headquarters, AKA "The Hospital", for my 10:00 A.M. appointment. They were busy, but that's no surprise. And running late.

The first step began at 10:20 when I was called in to have my blood pressure taken by nurse #1. Then we went into her rather nice office and she said, "Let's see, you're going to come in next Thursday for a left hip replacement."

I was ready to leave. We then looked at all the paperwork and the computer screen. She had mis-read the malady. Yes, all the documents say I'll be having a left knee replacement. She was sorry to have made such a mistake.

She took my medical history. I have done this several times before in recent weeks. When she was finished I asked her about all the things my surgeon said would be explained at this interview. She knew nothing about any of them and asked me, "Weren't these questions all covered in your joint replacement class?" That was the first I had heard of the class.

I am to arrive at the surgery check-in office at 5:00 A.M. on Thursday.

Next I went back to the waiting room to wait. Then nurse #2 took blood (lots of it) and urine and gave me an EKG. I passed that one nicely she said. Then back to the waiting room.

Then nurse #3 explained my anaesthesiology to me and mentioned, for the very first time, that I would have some nerve blocker surgery before my knee operation. I'll be asleep for it but they will wake me up after -- just in time to put me under for the knee surgery. She gave me several sheets of paper telling me what to do and what not to do the day before.

Then I left the Pre-Op waiting area to visit another waiting room for a couple of chest x-rays. I got out of there at 12:00 noon exactly.

Apparently all the things the surgeon said would be explained to me will be explained when I go to physical therapy after the operation. I do have a booklet from the surgeon telling me, along with many other instructions, to scrub the knee area the night before with the special soap provided. But nobody gave me any special soap. Or knows anything about the special soap. I'll use Dial.

All I can say right now is, "Just do it."

Research Study of Blood Thinners

When I met the orthopedic surgeon last Tuesday he mentioned I could take part in a double-blind research study of a new drug, a blood thinner. He added that this drug is, "not approved by the United States Food and Drug Administration." Not yet, at least. It will be compared with a drug that is approved by the FDA for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) after knee replacement surgery.

He gave me a 14 page contract-like legal document -- an Informed Consent Form -- and asked me to read it and decide, by the time of my pre-op interview at the hospital, if I would take part.

I have decided not to participate. The study appears to require a lot of followup visits and some tests that sound intrusive and stressful. Lots of visits to medical offices.

Am I expected to participate? I feel awkward turning it down, but I really don't want to be part of it. Deciding on having the knee surgery itself was a huge step for me. Now this question comes up. I am sure the surgery and recovery will be quite stressful enough without adding any more stress factors.

My Left Knee Has Been Acting Up

I Meet the New Surgeon

Last fall I told my regular M.D. that I really wanted a referral to a different orthopedic specialist. I had trouble communicating with the one I had been seeing for the past couple of years. And frankly, I didn't want him "working" on me. In November I got an appointment to meet a new joint specialist.

Well, I didn't actually meet him but I was examined and interviewed by his Physician Assistant. He looked at the x-rays and told me that I need a knee replacement. I asked, "How soon?" And he said, "Can you be here tomorrow morning?" But seriously folks, he said it needs to be in the next two or three months. "Call us when you are ready."

In the middle of December I was ready and called to start the process. By then I was having lots of problems walking and used a cane all the time. A few days later the date for the surgery was set -- late January -- and I went in to meet the new orthopedic doctor.

I don't know why I was dreading this appointment so. Maybe I shouldn't have fired the previous specialist? What if I dislike this one as much as the former one? Does this appointment mean I am really going to have the surgery in three weeks?

An hour and fifteen minutes after my appointment time, in walks the doctor. He's friendly, soft-spoken and very reassuring. He immediately answered my first five questions before asking me what questions I had. I didn't have any other questions.

Yes, I need Total Knee Replacement (TKR) surgery for the left knee. Apparently it is the same thing as a Total Knee Arthroplasty (TKA).

The exam confirmed what his assistant had found: my knee needs replacing soon. Strangely when he was twisting my leg around to see how much play was in the joint (a lot) it didn't hurt much. For the past several weeks there has been less pain in the left knee. The right heel has been much more painful, especially at night. Either I have gotten used to the left knee or the pain transmitters have ground away along with some of my bone and cartilage. Maybe a little of both.

He told me I would be in the hospital three to five days and might need a few more days, perhaps a week, in a rehab facility. Rehab is unlikely as we live in a single story house and there are no stairs to deal with. And Jack will be here to help me and drive me to physical therapy for the weeks I can't drive.

The next step for me is the pre-op interview at the hospital next week. Then I'll find out everything I'll have to do before the surgery. And after.

If you really want to know more about the procedure, here's a link to the University of Iowa's TKR information.

Flu Shots for the 2008-2009 Season

"Ouch!"

Yesterday we got our flu shots. It's a fall ritual like Halloween and raking leaves. We went to Pensacola's Professional Health Examiners -- a one-stop service where you can get flu shots and paternity tests right in the neighborhood. Our real reason to go there is that we can get our shots and be on our way in about five minutes. Try that at Walgreens or the doctor's office.

There's lots of flu information at the Centers for Disease Control website and specific information from them about the coming 2008-2009 flu season. We will find out during the peak of flu season, in January and February, if "they" picked the right formula to fend off this winter's flu bugs.

Still have flu questions? Click and read Seattle's excellent Flu FAQs.

Seasickness Remedies

Because we go on a lot of cruises, we often get asked by friends, family and even strangers, "Do you ever get seasick?" No, we have never gotten seasick, but someday we might, so we sail prepared.

There are two remedies we always take with us when we cruise. One is a prescription drug, Transderm Scop (Scopolamine). It's a small patch you wear behind your ear. The effects last for three days. You see many people on the ship wearing these patches.

Modern cruise ships are so stable that seasickness is rare, but even old sea captains get it sometimes -- after years on the sea with no problems.

We also pack a box of another drug that's helpful, Bonine (Meclizine). It is a non-drowsy version of Dramamine and you do not need a prescription to buy it. It's a chewable tablet and works quickly. It is also useful for dizzyness and other kinds of motion sickness.

There are a lot of other medications and folk remedies people use to avoid and/or treat seasickness. Here's what About.com has to say about many kinds of seasickness remedies.

A post from January 2008 about staying healthy on cruises listed what we do to avoid getting the dreaded Norovirus and other shipboard illnesses. Click here to read it.

Man with a Sore Toe

On Friday I had to laugh when I saw this picture because up until the day before I was the man with the sore toe.

I have been working with my podiatrist since last April to fix my sore feet and toenails. Recently it has been getting better and we were down to just one last ingrown toenail. We had a breakthrough on Thursday (ouch!) so by Friday I could smile when I saw this picture. A few weeks ago it wouldn't have made me smile at all.

The image is by Barbara Street and I found it on the Guildford (UK) Arts Council's homepage.

My blog is working. Do flu shots work?

The blog is still up and running I am happy to say. I have no idea what I did to break the original. And no idea of how to avoid it happening again. Not one further word from Blogger to help me out so far either.

I did get myself to Pensacola Junior College early Wednesday morning for my flu shot. The shots were scheduled from 9:00 A.M. until 1:00 P.M. I got there at 8:30 to be at the front of the line. The nurses were just setting up in the Student Center. One of them said they were ready and handed me a form to fill out, took my $25 and stuck me with a needle. I was out of there 30 minutes before they were scheduled to begin.

Do the shots work? I hear that in some years the protection in the shot is not effective for this year's variety of flu. The health officials said get the shot. First it would probably keep you from getting the winter's flu. Also, as a bonus, by avoiding the coming flu you would be stronger and more able to handle the bird flu pandemic, if and when we have the bird flu pandemic. Perhaps.

Funny thing at Pensacola Junior College, unlike every other community college I ever heard of, there appear to be no parking problems. If you are a student or work there you need a parking decal. Apparently it's free.