Recipe for recovery
By JOHN CARAFOLI 
CONTRIBUTING WRITER

No one looks forward to surgery. As a healthy, active person I have always dreaded it, particularly the thought of being incapacitated for any length of time. For years I had pain and some limited function in my left knee, but through yoga, swimming, acupuncture and a few unconventional methods I was able to stabilize and maintain the situation. A year ago, I resolved to schedule elective surgery for a partial knee replacement, and set out on a thorough preparation process.


A food columnist takes the unusual step of preparing his post-surgery meals and toting them to the hospital in a cooler.

 

I began by researching current methods and practitioners, which led me to Dr. Richard Scott, a well-known orthopedic surgeon who practices out of New England Baptist Hospital in Boston. After meeting him, I felt I was in good hands, not only with him but with his supportive staff, as well as the hospital and its facilities. I spent considerable time planning for my pre- and post-op nutrition and care. Many patients don't realize that by resolving to take control of their own well-being and nutrition before and after surgery, they can greatly enhance their overall sense of psychological and physical well-being, and speed recovery time.

I chose the timing of my surgery with care. (Obviously this is not always an option.) I selected a time when I had finished my seasonal food-styling assignments and could count on there being little work in the weeks ahead. And since I am one of those people who dreads and tries to escape the holidays, scheduling surgery just before Christmas was perfect.

 

Making ready

The day before I checked into the hospital, I prepared several foods I knew were nutritious, satisfying and comforting - just what I'd want to eat post-surgery. The morning I left for the hospital, I packed and organized a small cooler of homemade goodies, including sliced boiled chicken, a container of garlic soup made from the broth of the chicken, applesauce, and a container of Greek yogurt (I ate the yogurt after the antibiotics were removed from my regime). These were some of my favorite foods, designed to buoy my body and spirits. The process of preparing them also helped keep my mind off the coming surgery. Despite all my careful deliberation, emotional preparation and thorough planning, I was still anxious about what was to come.

After an early-morning check-in and preparation for surgery, Scott worked his magic. Several hours later, I awoke to find myself in the recovery room. I looked up to see a pretty smiling face. It was Maria Herbert, my registered nurse in the operating room, whom I had gotten to know several years ago and who had introduced me to Scott. ''John, you've got your 'uni' (compartmental knee replacement),'' she told me. ''The operation went extremely well. Doctor Scott said you were a perfect candidate.''

I was relieved to hear this, given my trepidation going into surgery. With the operation successfully completed, it was my turn to take control of my recovery, with the help of several wonderful caregivers over the next five days.

 

Healthy, but hungry

As is often the case post-surgery, I was not allowed to eat or drink anything for what seemed like eternity, with the exception of small cups of ice. After a couple of hours, the physical trainer came to see me. It was time to move. I was given a walker and shuffled around the room for five minutes. Then back to bed and onto the CPM (controlled passive movement) machine, a device that moves the leg rhythmically up and down, exercising the knee at varying angles. No time wasted here!

That night I didn't sleep - one doesn't sleep much in the hospital. The next morning, exhausted and weak after not eating for 36 hours, I was served the classic liquid diet - Jell-O, a small carton of apple-cranberry juice, and hot water with a Lipton tea bag. Not much nutrition here, I decided, so I immediately traded the Lipton for green tea I had brought with me. The nurse asked how was I doing following the anesthesia. I told her I had an upset stomach, but it was due to all the sugar in the liquid diet. I asked for a few crackers, which were allowed.

Late the next day, after having not slept or eaten anything substantial, it was time to exercise with the physical therapist again. When I tried lifting myself out of bed my body reacted as it usually does when it lacks fuel: I broke out in a sweat and felt I was about to pass out. Several doctors and nurses ran to my bed. A few hours later, after I'd rested and tests had been taken, I called the nurse and said, ''I need to eat!'' I needed protein, and I figured if you don't ask, you don't get.

She looked at me hard, then told me, ''I usually don't allow this, but you seem to know what your body needs. Here's the menu.''

Within 45 minutes I was eating scrambled eggs and sausage and drinking more of my green tea. Already I was feeling better.

A few hours later, my partner, John Murelle, came to visit. He removed the garlic soup from the cooler and heated it in the microwave down the hall. When he brought it to me the aroma permeated the room with the heavenly scent of chicken soup and garlic - sustenance for a starving man! For the next four days I proceeded to eat small, light portions, mostly protein, such as the slices of my boiled chicken, as well as the applesauce and yogurt I had brought along, supplemented with mixed baby green salads from the hospital menu. I consumed great quantities of fluid and avoided sugar and starches, which worked for me. On the next-to-last night, as a treat, John delivered dinner from one of Boston's top restaurants - grilled wild salmon, green beans and a tasty Mediterranean salad.

 

Alone, not lonely

I began writing this article on Christmas Eve, propped up in bed and listening to my favorite CDs. Even though I was alone in the room on a night when most people gather with their families in celebration, I experienced no loneliness or sadness. It seemed a perfect time to reflect upon my situation. My room, sunny and bright during the day, had large windows facing west. I could see the Blue Hills ski runs in Milton capped with snow. Each evening I watched the sun set, admiring three beautiful flower arrangements, which special friends had sent, perched on the windowsill. I was receiving the best of care from the hospital's dedicated nurses and staff, I was loved by my friends, and my spirits were high. I was feeling joy and peace during a journey that was, and continues to be, traumatic and difficult.

I progressed much more quickly than expected. On the third day I stopped taking pain medication and the IVs were removed. On the fifth day, Christmas Day, I was released from the hospital, whereupon I came home and cooked a splendid dinner of free-range chicken and roasted vegetables. Afterward John and I sat by the fireplace and opened cards and gifts. It was a happy day, thanks to the care of excellent practitioners and the love of friends, helped along by careful preparation. The journey continues with rehab and home-care help, but I feel confident that the worst is behind me, and the best yet to come.

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If this recipe seems too much for you, it may be scaled down. Have your butcher cut the hen in half, then wrap it and freeze it for use at another time.

Chicken Soup

One whole free-range chicken*

1 large onion, peeled and left whole

1 large carrot, peeled and cut into 2 or 3 pieces

1 large celery stalk, cut into 2 or 3 pieces

6 parsley sprigs

1 bay leaf

6 to 8 white peppercorns

*For a richer stock, you can add 2 to 3 pounds of chicken wings or legs to the pot.

Remove the neck and innards from the cavity of the chicken. Rinse the chicken under cold running water and wrap in cheesecloth. Place the chicken in a pot so it fits snugly along with all the other ingredients; add the neck, giblets, and (if desired) liver. Add cold water, enough to cover the ingredients, about 2 quarts. Bring to a boil. Immediately reduce the heat to very low and skim off any foam that rises to the surface. If this step is not done the broth will become bitter. During the first half-hour of cooking, check frequently and adjust the heat to prevent vigorous boiling, which causes the ingredients to disintegrate and makes the soup muddy. Cook, partly covered, at a simmer for at least 1 to 1 1/2 hours. (Sometimes I leave it longer to extract more flavor, but for most purposes 1 to 1 1/2 hours is enough.)

Remove the chicken. Strain the stock through a fine-mesh sieve or a colander lined with cheesecloth; let cool to room temperature. Refrigerate, covered, until the congealed fat can be lifted off, then freeze in pint or quart containers for future use. Makes about 2 quarts.

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Here is a thrifty way of using good leftover bread. The simplest version consists of just fried bread and garlic, with water for the liquid. Nowadays, I've evolved a slightly richer version using chicken broth and topping it off with grated Parmesan cheese.

Remember to allow time for the bread to get good and stale before you embark on this soup.

Garlic Soup

Half a long loaf of robust-textured Italian bread (use about 6 to 8 inches of the loaf), cut into 1-inch chunks

1/4 cup olive oil

4 to 6 garlic cloves, chopped

6 cups homemade chicken broth, heated

Salt and pepper to taste

Freshly grated Parmesan cheese (about 1 tablespoon per person)

Let the bread dry out at room temperature until it is rock hard. Heat the oil in a deep, heavy skillet over medium heat; it should be hot but not fiercely hot. Add the bread and brown in the hot oil, turning frequently, until lightly browned on both sides. Add the garlic and cook, stirring occasionally until just lightly browned but not burnt.

Pour the broth over the bread and garlic and bring to a boil over medium heat. Reduce the heat and let simmer until the bread falls apart, about 10 to 15 minutes. Season to taste with salt and pepper and serve with grated cheese.

Serves 6 as first course.

(Published: January 11, 2006)