The curve ball

Life is sometimes like a baseball game. As a batter, you might be unprepared when the curve ball speeds your way, but you know the win relies on how you manage that unexpected pitch. You can strike out at it in anger and miss, you can send it afoul, or you can smack it with all you have in you, hopefully for a base hit or even a homerun. And it all happens in the proverbial “bat” of an eye.

Twenty or so years ago, my husband, Chandler (Matthew in my book), literally fell out of a tree. He was cutting tree limbs when he lost his footing on the ladder, plunged downwards, and took the brunt of the impact with our concrete driveway on his left heel. When my son ran into the house and told me to call an ambulance, I called right away, then rushed out with my heart doing flipflops to see him lying on our lawn, writhing in pain, a small bone poking out the side of his foot. The damage on the inside, however, was worse. His heel had been pulverized, and the resulting surgery, ten-day hospital stay, and three month recuperation left him with a misshapen foot full of screws and plates, two sizes larger than his right foot. He limped for years, and then one day the limp went away, only returning occasionally after long walks and excessive stress. But by and large, it was forgotten.

Then, in March this year, God touched us both on the shoulder and said, “Ahem, you there with your comfortable routine, don’t be so complacent. I’ve got news for you. Your life is about to get a little more complicated.” And He was right. I had been mildly worried because Chandler, who has battled diabetes for decades, seemed to be sleeping far more than usual, and he had complained about pain from a tiny lesion on his heel for months as it had steadily worsened. But being male, the thought that he might want to get checked out by his doctor had not crossed his mind, nor did my gentle urging make an impression. But on this particular Saturday, after he had slept all night in his recliner because he couldn’t walk to the bedroom, I took his temperature, and seeing he had a mild fever, insisted that we go to the nearby free-standing ER. His foot hurt so much, I had to go into the building ahead of him and request a wheelchair. I assumed they would treat the spot on his foot, load him up with antibiotics, and we would head home so he could rest and recover. Instead, that night found him in the hospital, in ICU, with a septic body. Two doctors told us he would most surely lose his lower leg. I went home late that night with my head spinning. How was he going to manage with a missing lower leg? Could he ever adjust? How would our lives change?

But they didn’t amputate. The podiatrist on call met with us the next day and said he could save the foot. Thank you, thank you, thank you! Chandler saw a boatload of doctors during his eleven-day stay in the hospital – an infection doctor, a kidney doctor (the onslaught of antibiotics did a nasty little number on his kidneys), the floor doctor, and the foot surgeon, who performed both a biopsy and surgery within two days of his hospitalization. I was shocked on the second day of our stay, a few hours before the surgery, when the infection doctor picked up Chandler’s foot, and it was literally dripping with infection weeping from that tiny hole, which had become larger. He told us all the metal in Chandler’s foot was the culprit, along with the diabetes. According to him, internal metal is like a magnet, to which infectious cells stick and multiply far more rapidly than on any other internal surface. He expressed concern about infection in the bone, but according to the podiatrist, it was impossible to say if it was there because the metal blocked all attempts to see inside the bone. So, that night, he took bone biopsies through Chandler’s heel, and performed surgery a day later on the side of his foot, leaving an ugly open wound all the way to the bone, so the infection could drain. I was shocked, afterward, when he told me he had only removed one screw and left the rest of the metal in Chandler’s foot. That was the first time I began to question this surgeon’s judgement, especially after what the infection doctor had said.

So, the following week and a half was spent with Chandler attached to an uncomfortable wound vac and multiple IV lines and me sitting in the most butt-numbing, back pain-inducing chairs imaginable as the hours crawled by.

When we headed for home, with Chandler sporting a gigantic inflatable boot and a wound vac attached to his foot, I was worried about my part in this journey called “life.” My phone calendar was packed with upcoming doctor visits, and our front door became a revolving door with all the medication deliveries and home health nurses, who came in to change his dressings every other day. The majority of the nursing chores fell to me, and I was not prepared, facing even more complicated tasks than I had after his accident 20 years before. Making sure he had three nutritious meals a day, sans the extra carbs, arranging his medication schedule, including multiple insulin injections, and administering his IV antibiotic were not familiar to me. And, as I had expected, my days were definitely not my own and couldn’t end soon enough. At first, he was extremely weak and couldn’t walk on his walker, so getting him to the doctor, including going inside and requesting a wheelchair, then pushing him to where he needed to go, was exhausting for a 70-year-old woman, but gradually he began to get around with his walker, venturing farther in the house as the weeks progressed.

Then, a month later, another bomb dropped – a completely unrelated event. And yet also related. When one part of your body is under attack, all your body’s twelve systems are vulnerable. He had been making good progress when, once again, he began sleeping more than usual and complaining about being so “tired.” A few days after those complaints began, I walked into the bedroom, and he was lying half-on, half-off the bed and was almost completely unresponsive, saying over and over that he was “too tired.” Frantic, I called an ambulance and was shocked when they said his blood pressure had plunged to a dangerous level, and his blood sugar had skyrocketed. I had been texting my concerns to his home health nurse for a couple of days, but when I told her he had told the paramedics he’d had black diarrhea for three days, she chimed in with the same response they had: GI bleed. He was bleeding internally. So he was rushed, once again, to the hospital’s CCU unit, where he remained for six days, while his missing blood was replenished and his dehydrated body rehydrated. And a new doctor was introduced to the mix, a gastroenterologist. He had bleeding ulcers. This time I was angry at him. Why had he not told me or the home health nurse about the black diarrhea? Even I knew that was a sign of bleeding. MEN!!!! After this fiasco I told him he owed me a sizable piece of jewelry.

So, we went home, and started over again, acquiring a new doctor – the wound care doctor we saw once a week at the wound care center. Concerned about a new wound opening in his other incision, she repeated the same medical certainty the infection doctor had emphasized: metal is a magnet for infection. Our doubts about the foot surgeon grew. Our two follow up visits to him had been very unsatisfying. He swept in and out of the examining room as if in a hurry, just like he had at the hospital, and he never even took the time to unwrap Chandler’s foot and look at the wound. On a follow up visit with our primary doctor, when we told him about the struggles with the wound, the fact that the metal was still there, and the dismissive attitude of the foot surgeon, he jumped up and left the office, and within minutes we had an appointment with an orthopedic surgeon the very same day.

Our visit to the orthopedic doctor was both a breath of relief and a crushing disappointment. He insisted on a special test to see if there was infection in the bone (there was) and said that without removal of the metal in Chandler’s foot, the likelihood of a return of infection was pretty much 100 percent. Hence, on May 25th, we started the third leg of the journey – another surgery to remove the metal, but this time a day surgery that didn’t leave him weak as a kitten. Our routine changed once again to daily visits from the home health nurse and six weeks of four infusions a day of antibiotics – which I administered – along with hyperbaric therapy at the wound care center for two hours a day.

And that’s where we are today. With a couple of weeks of hyperbaric therapy and antibiotics yet remaining, we then wait two more weeks to see if infection has revisited the bone, and if it has, the last resort is amputation – back to the first prognosis five months earlier. We know that’s a very real possibility, and if it happens, we have more readjustments to make, as Chandler learns to walk with a prosthesis. He wondered, when our new surgeon suggested that another surgery was needed, if he should just go ahead and give his lower leg up, but I reminded him that his surgeon probably wouldn’t do it without pulling out all the stops to save it first, and that even if he had it removed, he would always have questioned if it could have been saved. But whatever happens, we’re ready – ready to move on, and thankful that he will be able to return to a normal life, with or without a foot.

And there’s always a silver lining surrounding the gloomy clouds in life. He’s lost forty pounds and gotten his diabetes under control with only medication. In fact, sometimes it goes TOO low. And his high blood pressure, a battle he’s fought for decades, is under control with one medication, whereas for years he had been taking two. He’s learned to eat right, he’s driving again, and he’s hobbling around pretty well in his boot. We no longer see amputation as a death sentence, and HOPEFULLY he’s learned to listen to what his body is telling him. Oh, and he didn’t give me that sizable piec

e of jewelry I joked about. He gave me a new car. I named her Scarlett O’Hara. Like Scarlett, I had no idea of my own strength till I was forced to climb out of my comfort zone. I learned I could make a dazzling ball gown out of a dusty pair of draperies if I had to.

So, Chandler and I hit that curve ball, and we’re still running the bases. I dare you to pick us off.

Addendum: January 24, 2019

Well, it's been almost a year. The foot is still intact, but the wound has never fully healed. More visits to the infection doctor and subsequent tests have confirmed (once again) that there is infection in the bone, controlled by Augmentin, an antibiotic, that he will likely take for a lifetime. His visits to the wound care doctor have been cut down to once a month, and home health dresses the wound three times a week. It's become routine that the wound will seal over, then a visit to the wound care doctor dashes our hopes once again as she probes around and opens it up each time so the infection won't "brew" and get worse. All the doctors concur that this will be status quo until the day the foot gets red and swollen, indicating the infection has spread...then amputation - no question. For the time being, Chandler walks like any other person, though not far because the pain prevents long walks. I worry about his lack of exercise (I should be worrying about my sedentary self), though his attitude is about as good as one would expect, given his limitations. After all, he is 73 years old! So, we wait for the other shoe to drop, a particularly apt metaphor in this situation, and park in the handicapped parking spots at Walmart, along with the zillions of other Baby Boomers. Life does, indeed, go on.