Wednesday, October 17, 2018

Managing My Stuff

Now that my infected wound is healing I can look back on last week and like rolling your tongue in the gap created by a recently missing tooth, I can think back over my feelings about learning I was infectious. I can think about it over and over, rolling my tongue and feeling the jagged gums and the edges of the hole formerly filled with ivory. It doesn’t do much good but it makes me understand, by force, how anxious I suddenly became. It was thanks to Johann my anxiety fell away. 

Johann is a physician assistant and wound care specialist and he speaks perfect English with a slight German accent. He grew up in Mexico. Intrigued? Me too. He combines elements of human warmth and decency with elements of science and learning to produce the perfect bedside manner. I am on call twenty four hours for you he says but once he has inspected your wound or looked over your chart you don’t need to be bothering him. He arranged my wound care treatment and I am on the path to healing. He monitors the nurses, goes over treatment, smiles shakes my hand and magically I am well. I rest easy. 

I was scared rigid when they said I had MRSA. The medical professionals shrugged it off but I knew the bacterium could do terrible things. And then Ketty, my superb nurse’s aide asked me if I was scared as I lay dying in the road? She knew I wasn’t. So why you scared now she asked with perfect Creole logic flashing her brown eyes at me like a Valkyrie...Because I said.  Because I have time to think? Because I don’t want to be eaten alive by flesh eating bacteria? Because I don’t know why.  You silly she said as she fluffed up my fresh sheets and I wanted to bury my face in her bosom for reassurance. I said nothing as she counseled fortitude. Behave she said smiling and ending the counseling session. 

Time proved Ketty -and Johann- correct. My expectation of a trouble free linear recovery got back on track. And Johann and I have a background in common it turns out weirdly enough. It turns out his Dad was a German engineer who got offered a job with a German company in Mexico. He married a Mexican in the decade he lived in Mexico, but as Johann put it with a wry smile the Mexican way of doing things got to him and he went back to Germany eventually, to the land of on time orderliness.  Johann split his time in two cultures in the same way I grew up with an apparently well ordered British father and an expressive Italian mother. And I suppose in the same way I couldn’t find comfort in one or the other neither could he so we ended up in the land of immigrants, each contributing in our way to mixing up our cultural histories. 

Physical therapy continues apace. I struggle to deal with ten percent weight bearing on my left leg which is attached to the most broken side of my pelvis. My broken right leg remains paradoxically the leg I have to put all my weight on. It’s hard heaving myself upright into the walker, holding my left leg light and flopping on hands and right leg. The more tired I get the less successful I am! But you have to persevere and I’m getting better. 

So much so I sat on a toilet in a test run yesterday, for the first time in six weeks I was on the throne. Felt awesome. And I kept practicing pivoting. Standing on my right leg, taking weight on my hands and swiveling to face a new direction.  Give me time and I will have it down. Just give me time and practice. And give me Johann’s  calm reassurance.

Tuesday, October 16, 2018

Toilet Training

I got a new wheelchair today which is the equivalent in here to getting a new car out there. Or a new pair of shoes if permabulation is the way you get around. A new wheelchair is a thing of wonder. It’s comfortable light and narrow so it fits everywhere, I can roll it and I can deal with the footrests relatively easily. I love it. 

Here I am smiling because Eddy and Elias are going to show me how to pivot and sit on the toilet. At this stage it’s practice runs but give me a few days and I’ll have it mastered I hope. I am still struggling to walk in the walker without putting weight on my left leg; if I had use of both legs I’d be laughing. 

I got a care package from Sheila in Key West who baked her backside off and made pounds of delicious sweet crumbly cookies. It was a hell of a gift and she made so many I have plenty to use, as she suggested, as bribes. It is a great morale booster. That and the cards and letters.  Glen in Colorado sent me a hand written note on paper and I enjoyed it as much as he anticipated I would. Fran sent me a follow up card and note for display! 

Having to be in isolation is a drag but I am still doing therapy. I put clean clothes on, wash my hands and make sure the dressing on the wound is sealed and I am good to go. And I do. In my new narrow chair I can use the rickshaw with both hands at once. That’s a first: 

You roll up between the handles and push them down while controlling their return. Over and over again. Which gives me strength to hold on to the walker frame as I practice walking on one leg. I sleep at night I exercise by day. I am tired. It feels like a job and I feel lucky to have it. Every day it gets a little easier to imagine a normal life again. Thank God for that. Thank you all for your encouragement, it means the world to me.

Monday, October 15, 2018

A Street Encounter

I met Candace as she meandered past my room on the main drag through the rehab. Because she’s a patient I’ve changed her name and I couldn’t photograph her but our conversation went as written. The main drag, our street:

I was in my room with the door open. Staff comes by and stops by my open doorway, for to come in requires suiting up, and they check up on me. Nurses and aides assigned to other units like to check on my progress and ask after my buddy Mersa, and they know I cheer up when a bright smile and sparkling eyes stops by.  But my net caught an entirely different fish as I sat in isolation lamenting my dearth of visitors. Ketty reluctantly modeling the MRSA protective togs:

A wheelchair came by and she paused outside my door so I said hello and we fell to talking. People like talking about themselves but in here it’s a good tactic too because you never know what agony they have been through unless they tell you. And spilling your fate first can leave you with egg on your face if you ignore protocol and go first and brash. Candace is such a diminutive figure in her outsize colorful bed jacket and tiny stick limbs all surmounted by the usual fluff of curly white lambs wool. Her story is one of iron will. 

The conversation began with an exchange of lamentations, difficulty sleeping, annoyances with the wheelchair, stuff that is the staple of people inside. I can’t walk I tell her with a laugh but it’s coming back. Her feet are in bright yellow physical therapy type socks with rubber strips. She was in an induced coma for two days. Ooh I ask how was it? Did you bypass heaven? No she says sadly I can’t remember a thing. I slept. She has dialysis because her kidneys don’t work so well. But then she has to control how much insulin her nurses give her as they have a tendency to overdo it and that would knock her out.

But it doesn’t end there. Pieces of her foot have had to be amputated. I’ve heard it’s hard to balance with toes missing? She agrees heartily. Very difficult. So she takes her constitutional in a wheelchair. Her husband went home to catch the evening service. I mumble something about Jesus promising not to overload us with burdens we cannot bear. She fired back the full chapter and verse and with an angelic smile and a promise to talk again she rolls slowly, steadily away. Leaving me wondering why the fuss about my pelvis. 

Sunday, October 14, 2018

Wound Care

My friend Webb Chiles is sailing down Chesapeake Bay on his world girdling 24 foot Gannet, I am in bed this Sunday morning with a view of the back courtyard bathed in Miami sunshine.  My wife who understands my needs even from afar sent me unsolicited pictures of her life outside, “in the world” doing banalities like walking Rusty and doing Spring Cleaning which I love as I enjoy an uncluttered home. 

Rusty keeps an eye on proceedings from the shade of our utility trailer. 

I awoke from a nap this morning clawing my way out of a suffocation nightmare. The details escape me fortunately as there is nothing so dull as recounting dreams but it reminded me of my mental stress since the accident six weeks ago.  At first I couldn’t sleep because I kept replaying my agony as I fell asleep. Now I can sleep but while awake I have discovered phobias that previously never bothered me...

When watching Netflix I cannot stand seeing death scenes. The sounds of bones crunching set my teeth on edge and I squirm in bed. The sounds of vehicle accidents leave me breathless. All too often I cover my telephone screen and look away. I never had these sensibilities before. I suppose they were inevitable now I have long numb gashes in my legs and across my pelvic area.  I have been broken after 60 years and the pain of being crunched does not need to be brought back to mind. 

I had nightmares about a return to the hospital last week when they told me one of my pelvic incisions had developed the fearsome MRSA bacterium. There was for a day a tussle over treatment but in the end Doxycycline won out and it is beating back the infection. A cream treatment is granulating the necrosis and the wound isn’t oozing particularly badly. Check it out, as this is no holds barred recovery and rehab remember? You’re in this journey with me. 

That’s where they sliced me open six weeks ago to insert a screw to hold the left side of my pelvis together. There are several more cuts where they bolted all sorts of ironmongery into me. The big screw at the top is where the incision got infected. 

I have lots of lumps and numbness I don’t particularly want to explore on my thigh where I broke the femur in two places but my pain comes from the injured leg roughed up during physical therapy. Pain decreases and mobility increases. Lucky me. Wound care happens once a day, the gauze is removed and the wound washed and treated with cream to break up the necrosis, the black dead tissue. Then Serret, the nurse with the gentlest hands covers it up. I enjoy the nurses with the gentlest dispositions and we end up chatting.  

He came to the US in 2006 after a career as a doctor in Cuba. There are nurses and aides all over the place who had full medical careers in Cuba and gave them up to cross the water. I’ve started to recognize their talent in the way they accomplish menial tasks they are allowed to do here. We talked emigration for a while. 

Wound re-covered for 24 hours. No oozing no danger. MRSA be gone. Time for a nap and then some Facebook to take my mind off it. Recovery seemed so uncertain last week dealing with this. This week is better.  Now I wait for Webb to land and send me dispatches from the edge of his experiences. 

Saturday, October 13, 2018

Winter Closes In

From the Poetry Foundation this splendid meditation on the change of season Up North. I love the image of the darkness closing in outside forcing the poet to look in. Winter used to be that time of less activity and more conversation and thoughtfulness yet nowadays we create our own light.  Down south I find myself measuring daylight and darkness in the mornings as I ride home and prepare to walk Rusty...or I did before I got stuck in rehab! I hope you enjoy it. 

A Letter in October 

Dawn comes later and later now,
and I, who only a month ago
could sit with coffee every morning
watching the light walk down the hill
to the edge of the pond and place
a doe there, shyly drinking,

then see the light step out upon
the water, sowing reflections
to either side—a garden
of trees that grew as if by magic—
now see no more than my face,
mirrored by darkness, pale and odd,

startled by time. While I slept,
night in its thick winter jacket
bridled the doe with a twist
of wet leaves and led her away,
then brought its black horse with harness
that creaked like a cricket, and turned

the water garden under. I woke,
and at the waiting window found
the curtains open to my open face;
beyond me, darkness. And I,
who only wished to keep looking out,
must now keep looking in.

The Weekend

Layne left work yesterday and did some shopping along the way to see me.  Gary had advised the treatment for MRSA messes with your gut so my wife stopped at Publix and bought supplies to try to counteract the possibility of diarrhea. 

Not just painful diarrhea is possible but serious complications can arise in the event any fecal matter contaminates the MRSA. I feel like I have a portal in my side for any wandering or stray infection or microbe looking for a home.  I am washing my hands obsessively with the soap Layne brought.  They are using cream she brought to fight bedsores as this awful languishing goes on and on. She brought more t shirts and shorts as I can only leave my isolation under strict  hygiene rules and as long as the wound isn’t leaking. 

My wife’s appearance after a 150 minute drive lasted less than 15 minutes twice.  First she dropped off the supplies then she went to the laundry and sorted my outfits for the coming week. Rusty had to stay home of course. Then Layne came back and sorted my laundry and watched as I got my battery of evening pills and then left. Just like that. 

No closer than that.  She has had arthritis most of her adult life and doctors said she has to wait with her compromised immune system to get closer to the source of infection risk. Maybe she’ll be back Wednesday after I have been on Doxycycline five days. Maybe. As it was she got stuck in traffic on the turnpike and got home to a rapturous Rusty greeting at midnight. After a day at work all that...for me. Show me another woman willing to do that?! 

I did well in therapy on Friday. Elias says he may try to get me to the toilet on Monday as I seem able to pivot on my right leg. Despite a lot of walking Friday my right leg hurts less than it has and I have missed my last two appointments with the Percoset Express. 

When I say walking I mean shuffling. 
My left foot is on Elias’ toes so he can measure how much weight my non weight bearing foot is actually taking. Eddy on my right makes sure I don’t fall. Luckily I have enough arm strength to support myself but after 15 steps I am dripping with sweat. Ten weeks ago I strolled eight miles with Rusty in 95 degree heat. Next to my left hand you can just see my goal, a yellow cone. I was being cheered on by the other inmates at their various tasks out of frame. Natalie took the picture as she pushed my wheelchair behind me. That is how this old sack of potatoes walks for now. 

The level of attention we get in this place is phenomenal. Nothing phases the therapists. They have all sorts of amazing and clever tools to restore cognitive ability, upper strength and flexibility and the ability to think and use your limbs. Amazing place.

This is my world for now. Pictures stories and links to the outside world that interests you are much appreciated at my Instagram or Facebook. I try to read books some days better some worse but messages and pictures are lovely. Things I can no longer see. 
Have a good weekend. Thanks for reading. Hope this isn’t too dreary but it is all I have.