Monday, September 20, 2010

Medical Misadventures

July 10, 2008
OK, while I have been away, some major life stuff. I developed a little
ulcer on the bottom of my "good" foot, and was nursing it along for several
weeks, with some success. This was short-lived however, and the thing
suddenly took a turn for the worse. Over just a couple days, it abcessed
and by the time I got to the doc, it was into the whole foot. Over three
weeks, we did two surgeries, to no avail. The orthopedic surgeon worked
hard on the thing, but gangrene set in, and we ended up taking it off a
few inches below the knee, matching the other side, so I am now
officially footless. I will have to heal the stump, and get a matching
fake foot for that side, which will likely be an 8-10 week process.
But that was not the best part.
I came home from the hospital Tuesday, and seemed, under the circumstances,
to be recovering fairly well. By Friday evening, I was doing well
enough that the wife and daughter went off out of town visiting. I was
around functioning well, talking to a couple folks on the phone, and
having a good time. Later, I started to run a little short on glucose,
and drew up about 6 ounces of grape juice, which normally will shove my
blood sugar up 20-30 points, and levelize things. After a few minutes,
instead of feeling better, I began to sweat profusely, and started to
have trouble breathing. This process got worse over the next few
minutes, to the point that I called 911, and was barely able to croak
out my info to the operator. When the paramedics arrived, they quickly
and professionally ferried my sick arse to the hospital, and I passed
out in the ER. The hospital had all my info from my amputation visit
a few days before, and called my brother Conrad, whom I had listed as
an emergency contact. When he arrived, I was unresponsive and on life
support, my ph was 6.9, my glucose over 600, my potassium levels near
zero, my liver enzymes off the chart, my stomach was bleeding profusely,
and my kidneys not working. Essentially, I was Worm Chow.
The specialists did their thing admirably - later, (7 hours as it turned out) I heard
someone say "Mr Crews, open your eyes!". Sounded like a reasonable idea,
so I did, and was looking at a very tired-looking doctor, who said "he’s
back", and I heard applause. I was moved to a hospital bed (apparently
I was still on the paramedics’ gurney), and since I was intubated, a
nurse clapped a bag on the tube, and I didn’t like the way she was
handling it; I needed more air, so I took on the breathing on my own,
and heard her say "he is breathing through the bag. I’ve never seen
that before". An older sounding male voice said "let him". and I passed
out again. Just a couple of hours later, I came to again, much clearer.
I looked around (as much as I was able, around the breathing tube),
and counted 13 IV bags, a dialysis machine, a respirator, a stomach
pump, (I also had a stomach tube through my nose) 2 central lines
in my neck, and I don’t know how many other IV lines in my arms. My
wife was there, but in the ICU, could only visit 10 minutes every
four hours, and I was increasingly alert, and really bored. I pointed
to the TV, and the nurse, relunctantly, handed me the control, and I
fired up CNN.
I am now known in the ER as the "remarkable turnaround" - 36 hours
after coming in essentially dead, I was normal, alert, my kidneys were
working and the dialysis machine was gone, the respirator and stomach
tube were gone, I was down to three IV bags, blood sugar was well
controlled, my potassium, magnesium, etc were all almost normal,
and I was jiving and joking with the staff.
The remaining days in hospital were incredibly boring, but eventually
came to an end, and I am finally back home.
The team of ER doctors and ICU nurses did an incredible job;
these people are fighter pilots in the medical sense, and literally saved
my crippled arse, and I will be grateful forever. I still think though,
that none of the fine medical professionals involved know exactly what
precipitated this thing, (ketoacidosis) or what made me fall apart so quickly. They did
a stellar job of fixing me though.
What I have to do now is heal the stump of what used to be my right foot.
When the surgeon took it off, he folded skin from the back of the shin
around to the front, to seal it to a stringer of skin from the front, and
the result is a horseshoe-shaped ring of staples, almost 50 of them.
These staples are a source of pain; a lot of pain. Any movement seems to
disturb the staples, and it hurts. I probably have about ten more days to
removal of staples, and thus about 98% of the pain associated with this
thing. After that, the stump will be swollen and misshapen, and before a
prosthetic can be fitted, must be "shrunk", which involves tight wrapping
and powerful elastic socks to bring it into shape. All this should take
about 4-5 weeks, then there is the process of making and fitting the
prosthetic.
Can’t wait…

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