Another VA ER Saturday

Hey, anybody remember what we did last Saturday? That was so much fun let’s play Saturday, San Juan, VA Emergency Room again. This time Kirt rode in an ambulance.

The morning began with Castor Oil just like last weekend. This week there wasn’t the pain of butt ripping turds, yippie ki. What we had here was failure to defecate followed by reverse flow. You wouldn’t believe what came out of his mouth and nose. “Pat,” he bellowed like a dying bull elephant. I recognized my name or I wouldn’t have known it was Kirt calling me.

Getting an ambulance to not stop in the nearest town, but to go directly to VA San Juan took a little doing. In a sincere desire to ensure the best care for my guy I spoke probably every word I know in Spanish today. I knew I was in trouble when the EMT guy who was speaking some English to me relayed to his partner his opinion of the course of events. The EMT partner assertively told my neighbor Gerardo, to tell me something. Gerardo, who speaks no English, looks me compassionately in the eyes and ever so slowly, enunciating carefully tells me what all the guys think in (what else?) Spanish!  

With Kirt headed toward help I sat on the bed stunned. When I first saw my love, my best buddy in the whole world slumped in the wheelchair spewing like something out of a horror movie, I wanted to throw up, and cry and scream. My head had thoughts of blowing up. I locked the dogs and cat in the house and headed to San Juan.

The ER Doc had been told that Kirt fell on the bathroom floor, couldn’t get up and his belly hurt. No mention of vomiting, constipatation, Castor Oil, being incoherent, or that I had given him aspirin because I thought he may have had a stroke. Armed with this new information the doctor continued with what he was doing.

Short story treated and released; we were home before Sunday. On the ride he complained of pain in the long leg. The stump hurt less than the good leg. His belly hurt less than the whole leg. God, please let it be his back. 

New Amputee's First Hurtle

Quarter past five this morning, the sun lights up haystack looking hills along the northern coast; we’re on the road to San Juan. As drives go this isn’t a bad one until traffic screeches to a halt.  First post discharge doctor visit questions race in my head. Kirt tolerates the drive with a little help.

Unloading is easier when the entry attendants give a hand, but I can get the wheelchair out of the trunk fairly well myself. Kirt transfers easily. Giving him our gear and double checking that I haven’t forgotten anything we may possibly need takes the longest. Morning parking is a competitive event. With any luck a kind vet may lead me to the space he’s about to vacate. God bless our Veterans. They are the heart of the nation.

My husband can’t touch more than his coffee for breakfast in the canteen. Stress mingles with the discomfort from the drive. He takes another pain pill. By the time he sees the doctors, everything is wonderful. I’m happy to report that the doctors agree with him. The wound, which they debride is looking fine. Oh, happy day, Kirt hurtles the first post discharge appointment with rave reviews, yeah!

We request that he be taught how to use crutches, so he can do more than transfer and head home to Lago Guajataca. 

The Rocky Road to Recovery

Almost 24 hours in an ER overwhelms on a good day. Somehow we’re never having a good day when we go to the Emergency Room, yes, 24 hrs. in emergency. Finally he had a good poop and went home. Happy Mothers’ Day everybody! And thank you, apparently he couldn’t have done it without you.

Today, stormy Monday sees grey enveloping all. Rains’ steady roar ringing in my head drowns the jazz radio station playing in the living room. Nothing but grey invades the day, but it’s not dark. My introvert loves days we can be alone together. Chi-Ping and Smoki are puddles on the floor around my bed. Blondie is at my feet. My Honey is in his room. Today, it’s good to be me.

Tomorrow will start on the road to San Juan. Did I tell you about the fool’s errand I was sent on last week? Run down to the VA San Juan with a prescription for medication to knock the socks off his pain. When he hurts it’s a son-of-a-gun. Rush hour traffic demands endurance I no longer possess, but there I was in early morning parking lot, I mean expressway traffic. Bitch, piss and moan, but I made it. It was early in the morning, so the wait to hand in the prescription wasn’t “killer.” Next wait, to pick up prescription could happen any time before close of business. Basically this is a whole day venture for me.

The line to pick prescription meds was short, when the guy at the window where the meds are given told me to go back to Window 2. That’s where the Rx is handed in; this isn’t good. I just know it. They’re not going to hand me his meds in the privacy of a small room and wish me a safe trip. I could feel my eyes bulge out of my head. The pharmacist is going on in Spanish about his meds. My answer is simple; don’t know what the doctor wanted to prescribe, call him; let’s get whatever it is so I can get back home. Through a haze of Spanish it becomes clear. I am brining NOTHING home.

Double the dose of what you have and bring a new prescription with you when you come to the next appointment. Son-of-a-gun, if that didn’t make sense. Why did I have to drive about two hundred miles round trip to find out? I was supposed to tell the doctor what? No, we don’t get trip pay.

So tomorrow, San Juan; we see the Docs. We are not ready to hear more above knee talk. Last year Kirt’s toectomy took ten months to heal. Kind of tells about the quality of circulation in his right. Tomorrow we’re talking left leg all the way. The suture/staple line is mixed with a couple of areas closed between big gaping separations with big scabs. In the middle a clear exudate continues to drain. Diana, the home care nurse does a bang up job of cleaning the wound. I’m glad to have her on the case.

Just when I think pick up the medication and go home something always happens and on Mothers’ Day when not too many were around I got stuck in an elevator. After a while that’s unnerving. The policeman who got me out steadied me. It can always get worse somehow always taunts at moments like this.

See you on the road to San Juan. Bendiciones.

Home From the Hospital, Now What?

Home from the hospital post op below knee amputation with wound separated from the staples, in pain; now what do we do? I wish we had an answer.

Each day we start with medication. Thank you, God, for the chemists, who make lives tolerable, when they are not.  Meds, some days are the only answer, but it gets better.

Kirt gets bored, every five minutes he’ll call, “Can you give me some…. Can you get me some…. Would you get it for me, is my personal favorite. Before of course, Dear, becomes sarcastic we must have the talk about planning wants and needs. Don’t wait until I get back in bed to tell me you just filled the urinal. That’s not funny.

The muscle spasms Kirt had in the hospital continue with his knee popping back and forth. The stump leg looked like a giant crochette hook with him holding it writhing in pain. We found that holding the lower leg in a gentle traction help with the cramps plus his knee extension improved. On the dark side sometimes he had rebound cramps if I pulled too hard. Kirt asks to have his leg pulled, so I’m a leg puller with a reference. Today for the first time in a week he had cramps; not the hook screaming variety. Gracias a Dio.

Since our talk Kirt is getting exercise by doing more around the house. If I don’t make the coffee fast enough, he is set up with filter, grind, beans, etc. to make it for himself. He looked proud this morning, as he brought my first cup of coffee. Sweet.

VA Stay in Time Perspective

The beauty of life for me is that given time and distance the better memories rise to the surface. Yesterday at the VA, where I was sent on a fool’s errand, smiling nurses and doctors appeared in my vision greeting, “How’s Carr?”

When I walked through the corridor, the nurse I thought of as the “dark hulk”, who would wake Kirt up with a raspy voice, “Carr, show me your arm band.”  The grand baldheaded silhouette towered over us, shading the suddenly bright light with his form. It became a regular morning treat, well, some days not so much, but a quietly competent, sweet, gentle man; we’ve come to know.

Tell you the truth, during the stay I felt like my brain sparked and caught on fire. Sometimes the top of my head felt hot, shit, it hurt. Seeing my darling man so sad, so hurt caused my heart chakra to pulse; that scared me but what the hell I was in a hospital. The big ebony guy wanting, now, to know how Carr’s doing is my angel. Each morning he looked into my eyes and smiled from his heart. I wasn’t just, “La esposa de Carr.” He saw me. That was priceless. Thanks, God, and VA San Juan for hiring my “Dark Hulk Angel.”

On the third floor sweet Ada with the knowledgeable hands and eyes, who does wound care extraordinaire smiled, “How’s Carr.” When “Les Miserables” were in the hospital all I could focus on was anything perceived as not good for my husband. I felt so comfortable with charming Ada’s skill. I allowed myself to go out of hearing range. My conversations with friendly confidants during these times kept me somewhat sane. Thank you, God, Ada, and my friends, Cheryl and Adri, for answering the phone.

Dr. Rodriguez, the shrink, whom I admire a whole bunch, Mary, the Social Worker, who does a bang-up job, and the Case Worker, Debra, maybe my favorite, all came for updates and well wishes. Dr. Aviles, the Rehab Doctor, who is one smooth dude on any continent listened to my description of Kirt’s leg, asked questions and gave me answers. Slam, bang, thank you and we’re on to the next item.

Next item is a whole “nother” story, which we’ll get to later. I just want to say that during the hospital stay it seemed natural to focus on the imperfections of a day. I’ll bet the shrinks have a spiffy name for it, like Patient Family Syndrome. When you love someone so much that you could go crazy with worry, no doubt, some of us can be a pain in the butt, but it’s all for the good of the patient; right! Thank you, VA, for seeing it that way. 

To make the rough times in a person’s life even tolerable is a tough job. Thank you San Juan VA; that’s all I have to say today.

Home from the Hospital

After two months in the hospital and three surgeries, my husband was going home. The drive graced with beautiful scenery went unnoticed as he stared at his leg with eyes filled with pain and sorrow, waiting for the brutal muscle spasms that have tortured him since the amputation, body tensing at every bump in the road, which is never longer than when heading home from the hospital; I thought as I looked at him holding his thigh.

San Juan faded in my rearview mirror. Memory of Kirt’s face the first time he saw the stump, flooded me with sadness. Loss so profound, unspoken, told by his eyes, when he took in his body and then looked into my eyes, slashed my heart. My pain at his loss is so great, how can he bear it? Greeted by green hills and blue ocean, Kirt began to look around.

Typically busy Friday afternoon traffic on the autopista/tollway demanded my attention. On rt. 22 there is a big charcoal colored fence with white birds that we noticed on our first ride west. He and I look at that fence. We smiled at each other for the first time in a while.

By the time we saw the exit sign for rt. 129 to Lares, Kirt’s pain meds were thin, so we pulled into the first gas station to medicate him before hitting the hills, the last leg of the journey twists and undulates. It will be the most challenging. I want the med to be kicking in good before we get to rt. 453. Some time is purchased at a roadside vendor along with watermelon, avocados and bananas.

Up the hill we go. I’m getting so tired. Two months of sitting by my husband’s bed hasn’t done anything good for my stamina, so all the running around and standing in line to get his gear and meds is taking its toll. It’s now rush hour on Friday. God, I want to be home.

On the highway the scenery enchanted Kirt, taking his mind off his pain. They don’t call this place La Isla del Encanto for nothing, but now we’re on bumpy country roads, that snake to and fro with everybody in a hurry to get home, including me. One thing about being a senior is that our limits become more clearly defined. I am burning out like a rocket’s red glare, so of course, I push harder. Kirt’s short leg went into spasm. He’s holding the leg in the air screaming as we hit a bump. Out of the corner of my eye it looks like he’s holding an elephant phallus. People want to get around us. It’s rush hour and I’m so tired, or maybe a little low blood sugar. I slowed down, so Kirt could get a grip on his pain and release his leg. Shit, I didn’t want Kirt to arrive home writhing.

From the car to the wheel chair, from the wheel chair to the bed transfers were made as quickly as I could manage. I ripped into his bag of meds to find the best pain management to handle him after the journey. The doctor told me he was going to step Kirt’s pills back a bit, but from 40 mg to 10mg, holy smoke, my eyes bulged out of my head, when I read that, but didn’t say a word. We focused on Kirt’s breathing. I held his stump in a gentle traction until the spasms subsided. We were home.

   

Another Day at the VA San Juan

Last evening about 9 pm concerned nurses called the rehab doctors, who informed them that Kirt had been seen about 3 pm and antibiotics were ordered; get them started. I won’t bother to rag about lack of communication or that I was in the day room making a phone call for five minutes when they buzzed in and out. By this time Kirt had a low grade temperature and much more pain. This shift of nurses did a fine job of getting him settled down for what promised to be a better night.

About 2 am Mother Nature called. Kirt transferred from the bed to the wheel chair with a fair amount of skill. The physical therapy paid off already, well, not too much. He got stuck in the bathroom, so I had to call in the night nurses. When he yelled, “I’m getting out of here tomorrow,” I wanted to cry. Once back in bed he writhed in pain holding his leg above the amputation. One of the nurses told him to stop squeezing his leg, that he was making it all red.

Where the hell do you go with a stupid comment like that? She kept insisting that he was responsible for the inflammation in the stump below the knee. I should tell him to stop doing that. Sometimes there’s no point in arguing, so I told her I’d get on that right away.

Just a little sleep and we’d feel better, but that wasn’t to be Kirt ripped his IV out when he dozed off. There was blood all over the sheets, in his hair. He needed a bath and linen change.

With all of the pain and negative experiences it’s easy to over look the really great nurses and care that he is getting. I don’t want to do that because some of Kirt’s nurses have been tremendous; Ada, the kind and gentle, Felix the great, Eileen, the love have tended to him, when he was at the end of his rope. My darling’s recovery will be in no small part due to these wonderful and gracious nurses.

When he recovers all the difficulties forgotten, we’ll remember this time more kindly. 

Counting My Blessings Part One

Around 5 am a pack of surgical residents assembled at the foot of my husband’s bed. Kirt covers his head with the blankets lately. He no longer wants to hear most of what they say. The graft failed. The big discussion centers on how much lope to lob off, a toe, a foot, maybe midway below the knee. Gee, I wish I had covers over my head.

Just yesterday morning I was ticked with everybody who gave me a cock and bull story about why Kirt was sweating profusely. I mean wet gown and bed clothes sweating. It’s not a high temperature. It’s not low blood sugar. Then it’s that he has too many covers on. Oh, please, how sick do you have to be to sweat the bed wet under the covers? Duh, do you really think I believe that?  I was insulted to be told that tale.

When I came back to see Kirt in the afternoon, he was wringing wet. I told the afternoon nurses, who all said, “Yes, it’s a side effect of the pain medication he’s taking. We’re going to wash him off and change his linen.” Ta-Dum! Nothing satisfies like the truth. Kirt won the bonus round with nurses who took good care of him; no, excellent care, putting ointment on his hinny and joking with him while they worked.

My eternal gratitude goes to the hospital for allowing me to sleep on a cot by my guy’s bed. He’s well medicated and sleeps soundly. It’s just good to be with him.

In the night, while surfing the net to educate myself, I found info about stem cell research revascularizing legs that otherwise would have been amputated.  Hmm, a ray of hope eased my mind. I curled up on my little cot, trying to crack my neck to get rid of an intense headache.

And here we are back to 5 am. Without a cup of coffee, I may not have a pulse. Needless to say I didn’t have a functioning brain; hence no discussion of stem cells, just cutting, more or less, was the question. The next couple of hours sitting in silence were agonizing. Kirt said he didn’t want to talk about it. My head throbbed. He needed time to grieve for body parts.

Later the vascular surgeon laid out the facts surgically, if you’ll pardon the pun. I asked her about the stem cell therapy for revascularizing legs. She said she wasn’t familiar with it. Something new from Indiana University, I could see the excitement in her eyes. She said she would know more about it by the end of the day!

Hope, thank you God for hope; I’ll keep the rest of you posted. Please, pray for this.  

Hospitalized in San Juan

Tell me that the usual causes of profuse sweating do not seem to be the culprits. Tell me you don’t know why my husband is sweating so much his gown is wringing wet, why his body is outlined with a sweat ring on the bed and his pillow, but DON’T tell me it’s because he was too covered up by his blanket that he’s wet with sweat. Everybody knows that if you get too warm under covers you kick a foot out or your arms and you cool off. No way you lie there sweating like a hog, and this is normal.  

At my insistence the intern came in to look at him. Ok, whatever caused the profuse sweating seems to be over, that I can accept, but now clean him up and change his linens.

The floor nurses are kind, loving people, who usually do a good job. I hate to be bitchy, but this is my one and only husband. So today if he wants a shave and his teeth brushed it’s up to me. After his bed bath, the nurse handed me his bowl and a couple of towels. I wonder what they do if the patient doesn’t have family present to his tidying them up?

The femoral bypass surgery done on Friday has failed. The doctors are planning to remove a toe this coming Friday. Hmm, yes the fifth toe that was pink when he came in two weeks ago is black as a lump of coal. The fourth toe, the one that was blue is the same. Don’t know if that’s good or shades of things to come.

Any day of the week great things happen in a hospital, but the same can be said for bad things. If they don’t do a graft revision, the prognosis is not good for his leg. It’s worrisome when I hear from the residents that the man made material used in the bypass grafts doesn’t work well, so they don’t want to use it. The literature I’ve read gives a better outlook than what I hear from these docs, so I have concerns.