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. 

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 

BY TED KOOSER

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.

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! 

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.

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. 

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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.