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.

Friday, October 12, 2018

Isolation

Jennifer the nurse came in around lunchtime and announced the results of the swab had come back on my suppurating wound on my lower hip. When she told me I had MRSA in the dying tissue of the wound I felt a chasm open under me which hasn’t yet closed as I write this. I haven’t Googled the bacterium known in the US as “mersa” because the results are I am advised not great reading.  However as far as I can tell the facility is interested in keeping itself MRSA free. Hence the instructions on the door to suit up as demonstrated elegantly by last night’s nurse’s aide: 

Yeah.  Here I am in Ebola ward. Does not feel great. It seems antibiotics will treat the infection and as the doctor said my life was in far more danger during my original operation than now which is I suppose some comfort. However dying of a tissue rotting inside out disease like MRSA seems, on the scale of things, a tad bit less clean and heroic than expiring of a driver’s distraction on the highway. Your thoughts and prayers as always much appreciated. My freshly installed door warning waiting to be filled with moonsuits: 



Now before people tap elegantly on my door I hear the scratching sounds of ten thousand ravenous rats at the door as the container sways and taps as arrivals pull down protective gear and suit up. Then the tentative tap at the door as though they are reluctant to enter the  leprosarium and as though I the leper, had no idea they were there.  Lord love us!  Two weeks of this...the mysterious plastic wrapped shadow. Sigh. 

The very good news is I have no fever (yet) and the wound is not suppurating a river of pus. What I am told is that some clear fluid is oozing slightly and as long as it is contained by the dressing I am free to attend therapy sessions. That was a piece of excellent news in a dramatic and fearsome afternoon. Fear filled might be more accurate. I focused on the good and after a delayed start for the medical conference I went  to try walking with Eddy and Elias and Natalie.

I sat in my wheelchair with Eddy to my right, Elias to my left and Natalie keeping the chair under my bum. I practiced standing and keeping weight off my left leg. Not easy. Then Eddy said it was time to walk. I took that as meaning I was doing better and I was. I was calm and determined and I focused on his precise instructions. I stood up left foot forward right foot back ready to push me up. Up I went with a little help from my friends. I stood straight. It felt good. A few of those and then we walked. With greater or lesser success I kept weight off my left foot and progressed across the empty gym. In several hours I covered by Eddy’s estimate a total of 14 feet. He was delighted. Witness his smile (and sweet hearted Natalie):

Elias my Occupational (upper body) therapist was also delighted:

Indeed it was a great ending to a crappy day. These people care about me and I am honored by their support. It felt good! 

Thursday, October 11, 2018

Stepping Up

I ran before I walked and now I have to go back and check my form.  My physical therapist Eddy saw me walking with the walker...

...and said I was putting too much weight on my uninjured left leg. That’s the leg that attaches to the most broken portion of the pelvis. So Eddy said we start again.  The past two days have been intense remedial. First learning to position my feet, left far forward unable to support weight, right tucked under me taking the full load. Then using my powerful arms and my right leg as a piston up I come weight biased to the right.  There I stand (when successful) looking around like bird freshly hatched enjoying the view from five feet up. 

Then I plonk back into the wheelchair my hairline rimmed with sweat, my breath rasping. Don’t be afraid Eddy says, as though the only thing I’m afraid of is falling. I’m afraid of twisting my knee and causing excruciating pain. I’m afraid of not being able to do it. I’m afraid I may be able to do it. I’m afraid my arms aren’t strong enough. I’m afraid of letting Eddy down. I am a mass of pretentious nonsense contained in my skin wobbling precariously between the past and the future. “UP!” comes the command. I rise on my right leg trying to ignore my left foot which rests on Elias’ foot so he can measure if I am doing it right or NOT. 

Eddy suiting up to take me in hand 
I rise up on the leg and he says good good good. And that means Elias can’t feel me putting weight on the left foot. The first time goes well, each subsequent attempt to stand gets a little more messy. No says Elias, too much weight, referring to my left foot on his foot. I rest. 

Elias and I
Then the big one, not just standing at the walker but using it to...walk. Properly this time with no weight on my left foot. I get coached.  “Walker. Left Foot. Right Foot.” That’s the mantra. I rise up and start calling the moves. Walker forward. Take left foot and move slightly forward, heavy weight on arms and right leg. Right leg forward. Eddy holds me by the belt, Elias supports my left arm and foot and Natalie keeps the wheelchair close to my butt. I got four steps in, the last being kind of crap with too much weight on my left. 

All that exercise is paying off. My knee hurts a little but nothing like the day before. Tomorrow I trust it will hurt less. I shall rise more gracefully. I shall learn to trust my right leg.  I shall walk with the walker. Soon.

Wednesday, October 10, 2018

House The Workers

The Key West Citizen reports a couple of major changes in business ownership in the city this week. Benihana has been bought by the people who own neighboring Trattoria Oceanside which announcement was accompanied by a promise to revitalize the businesses next to the airport. Let me be honest: I don’t care for dinner as theater so for the fans of the Japanese chain I’m glad to say no staff changes are expected.

The other bit of business news comes in the form of the sale of the whole Alonzo’s/Commodore/White Tarpon complex with the parking lot at Key West Bight now known as the Historic Waterfront etc..Alonzo’s I like.  A lot. And happily no changes are announced though some sort of mysterious enhancement of experience is apparently in the works. 

The Alonzo’s sale is interesting to me as a partner in the project is the same group of backers who got Stock Island Marina Village built which says something positive.  The new marina offers first rate facilities combined with a laid back neighborhood feel that has a food truck and dog park on premises, the sort of down home touches that give you hope they have an idea of how to treat people in this particular community. This could be a real good thing for Alonzo’s. 

North Roosevelt has been the scene of more wrecks. A couple of days ago an elderly man on a bicycle ride as run down and killed. Which when you remember the other cycling death in front of the Green Parrot last week is a reminder why Key West does not have a good bicycling reputation. Plus a car wreck led to injuries on the Boulevard along with lane closures recently. This is not tourist season either which makes it all the more disturbing. We are killing each other. The woman who cut me off is a resident too.  Apparently her husband has been going around saying I “broke a few bones” which is one way to get me mad after six weeks unable to walk or take a shit by myself.

All this exchange of business is a reminder that this is still Key West, the city with no housing. This is the place that accommodates the poorest and their meager belongings or the richest and their vast baggage train of expectations. The inbetweeners like you and me have a head scratching problem. There are developers trying to figure out some answers yet when workforce housing is proposed, on Summerland, Sugarloaf and Big Coppitt Keys the neighbors rise up in chorus and start lamenting the familiar refrain: Not In My Backyard. In which case we have to ask if not yours, whose? 

You would imagine a city with an ever worsening housing situation would be stepping up the search for solutions. The trouble is, in the Southernmost City there is money to be made from inertia so for now nothing is happening. No renovation of appallingly inefficient uncomfortable 70 year old public housing, no bold vision, no discussion of planning. Leave it up to a newspaper reporter to do for the city what the city dare not dream of...

Check out this aerial shot (from the web) of Ibis Bay Resort for sale.  Reporter Mandy Miles suggested the city buy it for workforce housing. Brilliant, no? Not at all it turns out. Give workers waterfront homes to rent? Hell no!  That’s the level of thinking we are at in Key West.  It’s a shame because this sort of thinking is what could put Key West in the bold innovative category of small city. 
————————-
On another subject allow me to take some space here and thank a couple of readers for their thoughtfulness. I am in rehab in Miami and lack access to the paraphernalia of the postal service but I received a note from Glen in Colorado who wrote me a very legible hand written letter full of pithy wisdom and humor. Thank you Glen.  Your initiative sending your letter to the police department in Key West was quite brilliant. 



Fran wrote and sent a supply of tea equipment which I have received with gratitude. I am glad I answered the phone and got the job done when you called 911 but you should have called back to introduce yourself. I am happy to have you buy me a drink! Chance encounters are way too haphazard. When I am back at home in my routine my email is conchscooter @ gmail.com 
My address if you want to give me a piece of your mind while I am helpless in bed for the foreseeable future with time to ponder your words, is:
Michael Beattie 
Room 508 
Encompass Health
20601 Old Cutler Road
Miami FL 33189 

Health South bought Encompass Health October 1st and adopted their name to sound less regional. The facility remains the same excellent rehab. 

Tuesday, October 9, 2018

Learning To Live

Rehabilitation is rebirth. It’s a matter of being restored to your fellows as a functional human being. For me it has become a process of learning to live again. I like to think the lessons will stick with me and were I 25  one would be dubious. As I am already in the final decades of my life I have high hopes these experiences carefully recorded here will influence my remaining years for the better. I can say I have found a measure of peace I would never have expected and even a loss of fear of death. Every day brings new challenges and joys and new human connections and I love every one of them. I am shaking off my introverted carapace. I told a good friend of mine - yes I am a good writer, an admission I’d never have made before. My life must be worth living if I have survived and flourished through this chaos. 

This Dali egg symbolizing rebirth ( he loved eggs) has been in my mind lately as I enter into the toughest phase of protracted rehabilitation. I am discovering the reason why Physical Therapy is often described as torture. The body which had been at rest and has been atrophying is now called to action so in addition to muscle exhaustion which follows naturally from exertion I have the pain of overcoming atrophy and the pain of exerting the skin around my many incisions!  It’s an interesting process. 

Havana 1933 in a Key West exhibit
Atrophy sets in three days after you stop using a muscle or ligament I am told by my therapists. My right knee was held rigid for five weeks and now suddenly needs to bend and support weight and so forth. It doesn’t exactly hurt but it feels almost as though the joint is encased in dried glue. Forcing it to bend feels unnatural. I do lots of exercises in bed to induce it to loosen up and in the gym too, pushing and pulling. 

I was comparing notes with a man who has lost the use of one side of his body. We ended up giggling at each other as I struggle to stand on one leg grabbing desperately at the parallel bars. When it’s his turn he forgets to move his affected arm completely while I noisily remind him. These movements all used to be so easy  we lament to each other.  Not taking anything for granted again in the future he says echoing a common theme among survivors of disaster. Cloaked in that sentiment we are wheeled off to our separate rooms and lives. 

Art of  Makiki of Key West at the Custom House 

Sunday, October 7, 2018

Rolling Through Life

I said it last night to my wife who was pottering around getting her clothes ready for her work week.  “I wish I could get up and walk.”  It’s a thought I haven’t uttered out loud since I lost the use of my legs on August 31st. My wife had her own doctor’s appointment in Miami then she went off home for the week to work and look after Rusty while I stay here and exercise my heart out. I took a few tentative steps while also putting my left foot more firmly on the ground than I should have done: 

As I become more physically active the restraints put on me by my wheelchair become ever more apparent. My chair is too wide for me and this creates numerous difficulties.  The back and the seat aren’t taut and the sagging produces a ghastly slump which becomes tailbone painful after a few hours. The wheels are so wide I have difficulty reaching the rings that I am supposed to use to propel myself. Often I resort to grasping the tire which is unsanitary and gets me yelled at. Even then the chair at 26 inches wide is a tank and an utterly unresponsive lump to move.

I send helpers out to seek out a 22 inch chair left perhaps by a departing patient to replace my monster. No luck so far. No response to my request from my case worker. I soldier on.  At least I am past the Hoyer Lift and now risk my neck by sliding from bed to chair and back: 

As long as you keep the plank under your thigh and don’t allow yourself to slide forward it’s quite simple. Strong arms help and an ability to wiggle. Meanwhile daily life continues. 

At home I use a safety razor and I stand nonchalantly before the mirror. Here it’s a bit different but I got the job done. Bit like the struggle to brush your teeth without dribbling toothpaste on yourself. It’s a whole different way to live.

A Perfect Saturday In Rehab

Friday night saw me grumpy in bed. My wife was coming down Highway One bringing the love dog with her when a failed passing attempt I believe at Mile Marker 72, near Duck Key, foiled her. 

It gets to be annoying for many reasons living along a single access road but this sort of nonsense, in low season no less, is doubly frustrating. No one died but the helicopter landed on the bridge to get a car occupant to Miami in a hurry. I didn’t envy her the flight...

As always with Facebook the details of what and why are absent. The pertinent news is that traffic was badly stalled for hours and I did not get to see dog or wife. I did get to speak by electric telephone with the wife. The dog was incommunicado.  Grr. I felt sorry for myself. 

I received word Saturday the highway was open and a second expedition was en route for my relief. I had a nice long chat with a friend. We sorted the world out and each other, a call that restored my equanimity and prepared me to meet my small brown bundle of love. It was actually pretty cool being able to get from bed to chair using a plank only. No more Hoyer Lift. I got this picture from my wife who witnessed my first attempts: 

She rolled me out to the courtyard where the breeze was blowing and Rusty ran around chewing grass and sticking his head in bushes. We sat in companionable silence and read, dropping comments on the news of the day into the peace of a bright warm Fall afternoon in South Florida.  It was pretty darned pleasant let me say. 



A neighbor of mine, Sonny who I’ve met and encouraged in rehab came out pushed by his devoted mother.  It was great. We traded war stories about coping with hospitals as only survivors can. It’s a small select group of us that knows the misery of ICU and the pain of recovery. My wife and his mother chatted about the vicissitudes of supporting patients in these strange circumstances.  It was good. 

I don’t know how you spent your Saturday but as odd as it sounds I don’t envy you.