Isla del Encanto Yin and Yang

Doctor appointments, nurse and therapist visits dot the calendar like dandelions in spring. Thank God, Puerto Rico doesn’t have dandelions! Impromptu trips to the ER in San Juan have been their own special brand of hell, leaving us spent in the wake.

Our home in Guajataca has special healing energy, the lake, the mountains; we thrive after surgery. Kirt’s incision is healing beautifully. Last year in New Orleans the other leg, toe amputation took forever, and hyper bariatric treatments, to heal.  My surgeries have also healed better once I got here.  

Kirt comforted a dying puppy holding it close to him in the final hours. He stared at the lifeless rear end with red eyes brimmed with tears. I could feel the strong gift of energy Kirt gave the pup to no avail. The little head gazed at him with peaceful eyes half closed, until just before the end she cried, loudly. I’m just a puppy. I don’t want to die. Slumped in his chair Kirt rolled to the bedroom.

 The concept of yin and yang works in hyper drive here. Pointless trips to San Juan followed by other trips, exuberant praise from doctors genuinely surprised to see his progress. Sadly, it only pisses me off to know how much they wrote him off. I am glad that they seem to be sincerely preparing him for the new leg. The prospect is renewing. When he can think past the pain and shit, he smiles as he talks about walking again.

Speaking of smiles, if puppies make us smile, this is Puerto Rico, La Isla del Encanto, hold on another puppy is under a van at the bottom of our driveway as we speak.  Let’s get him before a car does.

We have a new puppy. Aren’t we lucky? And so Lucky he is.  

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.

Two for Guajataca

Adventure in our senior years whistled come. We traded the windswept prairie all white with snow for lush tropical forest with papaya, banana and mango.

Familiar comfort, people, Midwesterners like ourselves, the same accent, all the things we liked, and didn’t like about ourselves, don’t discard lightly. The waitresses at the Silver Dollar Restaurant poured our coffee as we got out of the car. “What’ll it be, the usual?” Tidbits shared with a smile or a nod. These everyday moments cling, texturizing my life. We won’t say we were bored, no, never.

My God, to think about, running off someplace totally strange, well not totally, but close enough to cause friends to wonder what the hell possessed us. Life as a respected dog trainer with a kennel and all that gave me great pleasure for many years. A tractor, a bobcat, a few buildings filled with guy toys; what man isn’t happy in spite of himself?

Kirt and I are well balanced. My life has been running away from or to something, screaming; screaming what depends on the day or year. Conservative Kirt mastered the “what if” cautious approach early in our marriage. I know how to get something to work and he tells me why it won’t, or shouldn’t.  I hate it when he makes good points.

For more than a decade we talked about retiring to New Orleans, where we have friends and family. I love New Orleans, thank you Grandma! The very first time we landed in San Juan Kirt exclaimed, “This is where I’m going to retire. I’m going to live here!” My other half heard from and noted without more thought than of pigs flying. On Sundays my grandmother and I walked the streets surrounding St. Louis Cathedral in New Orleans looking in shop windows. She asked me questions about school, my friends, what I thought about this or that. What I thought; what a concept! How much would you want to re-visit that? Come on, that’s home for me.

Always listen when the quiet man speaks. Kirt usually supports me doing whatever I want, so when he has an opinion I honor it. We went to look at property. Bienvenidos a Lago Guajataca.  

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.

   

Puerto Rico Sunday Morning And Me

Sunday morning leisurely spent looking out bedroom window where trees dot undulating shade and sunlit pastures silent save the dove hooting in the big orange Flamboyant tree. Yesterday’s mown lawn smells green and rico enticing me to breathe more deeply, savoring the richness. I am loathe to lumber to the kitchen to make coffee. Did I say coffee?

Soon the scent of freshly ground coffee stirs me to take care of Kirt’s morning needs. The amputation wound is healing, looks like a great big circular scab. To be more precise it looks like somebody slashed him with a knife. I guess it looks like what it is; hmm, why that feels like a big revelation is beyond me, but so it goes. We have so much adjusting to do. It sneaks up on me sometimes. Usually I am busy enough and focused on a variety of things that I don’t allow myself to think too much about the changes in our lives. Well, this isn’t the first dramatic change in our lives, so as always, its one day etc, etc.

Still disciplined with many chores each week, but Sunday morning is my time. Here in Guajataca communing with the creator comes naturally. This, I believe, is some of God’s loveliest work. Landscape making me smile on a difficult day is priceless. Thank you, God. And thank you for the kind loving people of Puerto Rico. I have my difficulties with the language and the differences in our cultures, I love the way people go out of their way for one another. It isn’t universal. All the shit that happens in society is here like any place there’s people, but we receive so much kindness our hearts thrive and smile in gratitude to the people we meet on an average day. Yes, Cheryl, there is a reason we stay here and, no, we’re not stupid. ;)

Time to assist my darling with his shower so we can enjoy what man has made. We’re going to the mall. Enjoy your day!

Stay at Va Over

A two month odyssey in the VA medical system gave me sensory overload, starting with the ubiquitous room freshener. Symptoms began with headache, nasal swelling, sore throat. Oh, crap, was I getting a cold, which meant Kirt would get it, and then, I’d smell it, air freshener. I can’t be the only person in the world allergic to air freshener. This is the same thing that happened to me at the Hilton in Trinidad, where a fresh spray gassed the room overnight. An asthma attack froze my lungs after insisting my nose be closed. Thanks for your attention to detail. Ingesting the outdoor scent of chemicals is so much better than opening a window.

Kirt was treated to a plethora of experiences beginning with two weeks bed rest. At seventy what could be better for you? Then he was treated to a femoral bypass with staples from the crotch down his left inseam. The soft, chubby inside of my legs cringed every time I looked at his tender thighs. A fifth toe removal followed the bypass about a week later. Suture line quality made moot by below knee amputation around a week after toe extraction. The bypass surgery failed, but the suture line is healing beautifully until it intersects with below knee amputation. Trimming a nice flap for a stump must be perfected by OJT, on job training. I don’t imagine all flaps coming out of residency to be created equally. Kirt’s surgeon did a really lovely flap.

I thought the stump staple line had issues from the first time I saw it. One of the residents disagreed with me saying that it was beautiful; Kirt had held  his leg wrong, messing everything up. Leave it to a patient to screw up perfectly good work every time. Within days of the amputation the suture line was bright red radiating to dark further away, a couple of black spots looked to me like clotted blood, since then, the staple line has opened up in those areas. I would no longer even call it pretty. 

After the amputation, muscle spasms hammered his thigh and what remains below knee. Dr. Aviles, the excellent rehab doc, ordered calcium, which has helped decrease the cramps, and probiotics for Kirt’s intestines, but had no influence with the quality of breakfast whatsoever.

On Thursday, the surgery residents pitched another amputation on the basis of the poorly healing suture line and the stump healing at an angle impossible for prosthesis. Additional leg removal declined at this time, so Kirt was sent home on Friday. Hallelujah, saints be praised.