Update and Explanation

Originally written February 3, 2018, with updates to current time, 3/24/18

I’ve been away for a while, and I apologize, although I’m sure you are used to it by now; my protracted absences from the blog.  Allow me to explain this one, as at least I have an excuse this time.

I had my left big toe amputated in early November.  I spent five days in the hospital and another three weeks in a rehab facility recuperating.  Rehab facility is the term that is used when you are really too young to be in a nursing home, but in all actuality it’s where you are.  Some back story is probably in order here.  I have Type II Diabetes, and as discussed here before, heart issues.  I’m basically high risk for everything under the sun.  In late September, I was taking my shoes and socks off one evening, and my sock got caught on a callous on my toe for the fourth or fifth day in a row.  Without thinking, I grabbed the end of the callous, and ripped it off.  Immediately, I knew I had made a mistake, but there was nothing I could do about it then.  Of course, it got infected, and I went to my primary care doctor, who sent me to my podiatrist.  We were keeping an eye on things, and I thought that I had dodged a bullet.  I was supposed to be staying off my feet as much as I could, but I was recalled to the LMNC headquarters for a few days of immersion thera…err, I mean training.  This meant I had to do a fair amount of walking that week; through a couple of airports, around the corporate campus, etc.  I developed an irritation along the side of my toe, which I thought (perhaps hoped) was caused by trying to not walk on my irritated toe.  Once I got home, I had a follow up with the podiatrist, and she put me back on antibiotics.  A couple of days after that, the irritation opened up and was an issue.  I headed to the emergency room, they admitted me, and then amputated the toe.

I didn’t have a lot of time to really think about the amputation, which was likely a good thing.  I didn’t really consider life after the amputation, I just assumed that it would be gone, and I would move on.  I was concerned more about the anesthesia than I was about anything else.  As it turned out, my concerns should have been about life after the amputation.  I was unable to at least not supposed to put any weight on my left foot while the surgical wound healed.  That created a situation for me.  I was basically bound to a wheel chair for a period of time, and that is what lead me to the rehab facility.

The facility I was discharged to was, well, in a word, adequate.  That’s about as generous as I can really be.  A friend of mine described it as ghetto.  I quickly learned that the level of attention paid to the patients was significantly less than when I was in the hospital.  I was discharged from the hospital and transported to the facility on a Saturday evening.  Pro Tip:  Don’t get moved on a Saturday night.  The “C” Level team is working at the rehab facility on Saturday night.  I was surprised that there was no one there to do an “Intake” process for me.  No one described anything about what was going on.  I rolled with it on Saturday.  Sunday, I assumed that the Intake would happen.  It didn’t.  Monday I was greeted by one of the Physical Therapists.  I went to the PT Gym, and then she realized I hadn’t signed a consent for treatment.  I advised her that no one had done any Intake; no one had even spoken to me.  I raised a little hell with the administration staff that was now there on a Monday morning. We had a form of Intake in a seating area outside. And we were off…

Institutional Life is a drag.  I had 2 good hours each day I was there; the hour I spent in Physical Therapy (PT) and the hour I spent in Occupational; Therapy (OT).  Other than those hours, there was really nothing to do…You spend a lot of time waiting.  At least I did.  The normal rhythm of therapy was that you got passed around amongst the therapy staff, likely seeing a different person each day.  After the second time of someone asking me what I did the day before, I requested to work with a single therapist for OT and for PT.

My goal while I was there was too get out.  That may seem like an obvious statement, but a number of the older folks that were there, and honestly some of the younger people too, seemed to be content to just be there.  No one seemed to want to work that hard in therapy.  I wanted more.  They planted a seed with me that I might be able to transition to crutches, which would give me some independence, and allow me to go home.  I thought this wouldn’t be a big deal.  Then, in PT, I learned just exactly how weak I was.  I spent the first 10 days just trying to get strong enough to attempt to get around using a walker as crutches.  They didn’t have crutches at the facility for me to use in therapy (See the “adequate statement above).  Once we did get me up on the walker, the greatest total body workout I’ve ever had was trying to make a lap around the room with the walker.  The sweat was just pouring off of me.  We were progressing down this path when I was finally given a walking boot by the podiatrist, and forced my discharge.  I was free!

A couple of other anecdotes from my time there.  I really didn’t have any issues with the staff there.  You hear horror stories about the level of care, and there were things that had I been in a different situation may have been bad.  I was motivated to get out, am fiercely independent, and relied on the staff for a bare minimum of things while there.  They brought meals, and meds, and that was about it.  I took care of myself, largely beyond that.  As such, they staff didn’t have to worry about me, and we got along.  The management of the place, well, that is a different story entirely. As I mentioned above, I didn’t get any communication from the management of the place until I forced it to happen Monday.  So I was already identified as a bit of a problem.  Near the end of my stay, I learned that they had not been giving me all of my medicines.  Rather than relive this episode in its entirety, the Nursing Director got in a shouting match with me.  It was an issue.  I didn’t really have any choice but to take it from her.  She was in the wrong.  I just wanted out.  It’s been a very long time since someone basically got in my face, and was shouting at me.  Had she been a man, and I not in a wheelchair, I probably would have punched her in the face.  If she had been a man, even if I was in the wheelchair, I probably would have punched her.  It was a mess.  I really needed to get out as fast as I could.  The podiatrist gave me the boot a couple days later, and I had another confrontation with them to get me out.  It was time for me to go.  In forcing the issue to not stay there an extra day, they didn’t write or schedule any referrals for me.  This ended up being in my favor.  I took a week off from PT and OT, Between the hospital and rehab, I spent 3.5 weeks in a facility.  I just wanted to feel human again.  Being home was great.  The next week, I started PT and an exercise program twice a week, and that continues now.  I’m doing pretty well, losing weight, and out of the walking boot, and back t more or less normal.

I had an issue last week while exercising…I was experiencing some sharp pain in my shoulder blade.  It felt like chest pains…I went to the emergency room.  I had another “experience” at the hospital this time.  I went to the ER, I didn’t really think anything acute was wrong, but didn’t really know what else to do.  They ran some tests, and everything looked OK.  They wanted to keep me for observation though, given I am high risk.  They wanted to do an echo cardiogram too.  They told me this at about 2:00 pm.  I was in the hallway at the hospital…all of the ER beds in rooms were full.  At approximately 4:30 the accounting people for the ER came and extracted some payment from me.  I realized then that there was nothing else that they were going to do for me in the ER.  I was just waiting.  Around 6:00 pm they lead nurse for my ER section told me there were just waiting for a room to be cleaned.  At 7:00, when I was still there, she finally got on the phone and tried to make something happen.  At 8:30, I was finally taken for my echo, then I finally made it to my observation room around 9:30 pm.  The next morning, I had a blood test in the morning, and the PA from the cardiologist came by, explained that everything looked normal, and they were likely sending me home, but the cardiologist had to come by and see me.  By 4:00 pm, I was getting frustrated, and explained that to my nurse.  At 5:00, she asked if she wanted me to page the doctor.  I said yes.  At 6:00, with still nothing happening, I started raising hell again.  I went to the nurse supervisor, and got her engaged, paged the cardiologist, then talked t the nursing manager on duty.  It was time to test me, treat me or discharge me.  I was finally discharged that evening, with a mostly clean bill of health.  Trust me, this is the abridged version of events.  I held my patience as long as I could.  It did get the better of me, the waiting, and fighting the bureaucracy.

Fast forward to last week, I got re-associated with the cardiologist I had originally, had a stress test, and I have a follow up appointment next week.  More to come on this front, obviously.

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