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

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.

   

Today at the VA San Juan

After five weeks of sitting by my husband’s bed in the VA Hospital in San Juan I went home for a couple of days to pay bills, wash clothes and sit on the porch looking at the lake. The rehabilitation team introduced themselves in such a positive way; surely he was in good hands.

His first physical therapy came on Saturday. He did exercises for upper body strength. Reports from our friend Adri about his good spirits helped me relax. Tuesday morning when I arrived I expected Kirt to be headed for therapy, but no. His pain had increased; the amputation was cherry red and oozing. Around 9 am the nurse informed me that the rehabilitation doctors put in a consult to the surgical team for evaluation.

Kirt waited in pain, holding his stump, so I stalked the medication nurse from room to room until she came with the pills that promised relief. Slouched posture and I sure as hell don’t want to be here demeanor spoke volumes as she scanned my husband’s wristband. The first pill she popped out of the bubble wrap plastic. He was unable to take it, so with her long painted fingernails she scooped it out and plucked it into his mouth. Now, it’s been a very long time since I went to nursing school, but as I recall contaminating a patient’s medication is a no-no. She opened the second pill, I pulled out my cell phone and caught the photo of the long nailed vixen handing him the other pill. In between she pushed the hair back from her face, so in complete disgust, I took her picture. It’s too bad her hair fell forward again before I could snap it.

By late afternoon even the rehab doctors were annoyed that the surgeons had not shown up. They ordered that an IV be inserted so Kirt would be ready, if the surgeons ordered IV antibiotics. We waited some more. While a nurse checked his blood sugar I noticed the fingers on his right hand were bloody. I asked the nurse if she knew where the blood was coming from, the short answer was no, and then she left. I washed his hand and pulled back the blanket. His arm was bleeding from where he pulled out the IV. I walked into the hall with the needle and wad of tape, presented it to the nurse just in case anyone wanted to know where the blood was coming from other than me.

A little later another nurse came in the room while I was taking pictures of his stump. She curtly informed me that no picture taking was allowed at the VA. “Did I understand that?” I informed her I did not wanting to be escorted out by security. Police power is an intimidator.

As of this writing it’s now 8 pm and a still no surgeons. The redness is covering a larger area of the stump. Again I asked the nurses to call the doctors and was told they could not call the surgeons that it was between doctors. Either the surgeons will come tonight or in the morning. I’m afraid to cause too much of a ruckus because I want to be able to spend the night with him. I realize that it’s by the good graces of the staff that I’m able to stay to watch my husband’s condition deteriorate this night.   

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. 

Hospital Nightmare in San Juan

“Yelling at my husband in Spanish won’t help him understand you. He doesn't speak Spanish,” I informed his intensive care nurse. “Habla la lengua del pais.” She angrily said to me as my husband held his head.

“Why are you holding your head, does it hurt?” she shouted like she was taking to a deaf man. My love thrashed in pain, just hours after a femoral bypass operation. “Time to go, now,” Nurse Maria barked at me. I pleaded with the angry young nurse to let me see my husband relax after receiving his pain medication who said she would have to call security if I didn't leave NOW. My seventy year old darling became agitated. He pulled at his gown and bed clothes. My heart ached to stay with my husband of forty-five years, until he was comfortable again.  

This woman, who seemed intelligent and efficient, told me to get out so she could do her job. She would not give his medication until I left. My husband kicked reflexively with the leg she told him to hold still. She again ordered him in Spanish to not move his leg. She ordered me out in Spanish with un-called for vehemence.

Did she take offense because I told her that my husband needed to be elevated in bed? The foot of the operated leg was pushed against the foot of the bed. His toes have turned black since his admission to this hospital. I can only imagine that dying toes hurt on a good day let alone the day he has surgery on that leg.

I treat the staff with courtesy and respect. The floor nurses in the ten days he’s been in the hospital have been amiable. Some of them have had difficulty with English. I speak as much Spanish as I know. I like the language, looking forward to becoming proficient. We worked it out amicably. The surgical floor staff was wonderful to us.

The SICU nurse’s lack of compassion caused me worry for my honey’s well being. I sensed her competence at her job, but she lacked empathy. I told her I had to bring in her patient’s snore machine. His surgeon specifically said he wanted him to use it. I walked out to the car to get it, when I returned. No one answered the bell. It was after hours, but they knew I was coming back with it. I had to walk back to the other building in the emergency department to have someone call to get her to come to the door of SICU to take the machine. I wished her a good evening. Have a good night while taking care of my love.  She was working until 6 am she said before. She replied something in Spanish as she grabbed the bag.

I honor that Puerto Rico is a Spanish speaking country. I am learning the language, but the VA Hospital in San Juan is still a federal facility and my husband is still a veteran.