Sorry for the long delay in posting an update on my health situation, (for the last three weeks or so, my allergies have been kicking in REAL bad,) but here it is…
The VA has approved paying for the surgery down at UNM Hospital, and I’m just waiting for the paperwork to wiggle it’s way through the all the government red tape when they’ll make an appointment for me to see Dr. “Q” again. I’m assuming at that point he’ll schedule the surgery and tell the VA if he needs newer pictures and scans before doing the surgery.
One funny thing is the automatic messages that get sent back and forth is one that came from the paper pushers here at the VA where they asked if this surgery, (cutting out part of my left pelvis and amputating my left leg,) could be done as day surgery. LOL…
If my Dr, (“E”,) hasn’t heard anything by Monday, he’s going to give a call upstairs and see if he can’t get this process moving. I’ll be staying on the IV antibiotics until a week or so before the surgery, when they’ll stop it so when they do the surgery and send the various samples to the lab, they’ll see what little buggies are in there. Then, Dr. “Q”, (the UNMH ortho surgeon,) said I shouldn’t have to stay at UNMH for more than two or three days before I come back here to the VA to heal up and then start learning how to do things without my left leg attached, (like avoiding falling into the toilet when I go to the bathroom.)
When I went in to see Dr. “Q” for the consult, he said he had a surgical opening for about six weeks out, (mid-April at that time,) and hopefully the wait will be no more, and maybe even less, than that to get this done.
In other news, I had a small bedsore at the top of my right pelvic crest, and a couple days ago, had surgery on that to cut out all the necrotic tissue, and basically, the plastic surgeon, (who previously refused to operate on me because I’d never heal because I’d had radiation treatments,) turned a 2cm X 4cm hole with 2 cm of undermining into a 4cm X 6cm hole with 5cm of undermining that’s been bleeding through the dressings, (I’m on blood thinners,) and messing up my pajama bottoms. They’ll be putting a “wound-vac” on it on Monday which will take care of that problem.
What a “wound-vac” is is a getup where they put this sponge like material into the wound, then cover it with plastic with a small hole cut in it, and what looks kind of like a suction cup with a nipple on it goes over that hole. It creates suction which helps suck the wound closed, draws off excess fluids, and increases the blood flow to the wound to promote healing.
It’s a nice little device, but a pain in the ass since you have to carry around the machine itself, which is about the size of a skinny toaster, and get the hose all arranged properly so it doesn’t get tangled up in the wheels on the chair. I saw the wound today when they changed the dressings and it’s kind of disgusting if you’re squeamish, but it’s all nice red meat in there now rather than the white/grey stuff that was the dead tissue. Hopefully, that will help heal this bedsore up in spite of the terrible mattresses, (called a “Dolphin” mattress,) that we’ve got. I’ve got a much better mattress at home that has 24 horizontal cells down the length of the mattress, and it deflates one out of each three cells alternately so that every four minutes, (the way I have it set up at home,) any area that has pressure on it changes, and no part has pressure on it for more than eight minutes before the pressure is relieved and fresh blood can flow into that part of my body again.
I got this bedsore on my right side after we had a power outage at my apartment one night, (a drunk driver had hit a power pole somewhere down the line,) and I ended up lying on a wire for several hours without knowing it. I was healing it at home just fine by packing the bedsore with what’s called “Aquacil”, (which is like felt when it’s dry, but turns into jelly when as it soaks up fluids coming from the wound,) with just a dressing over that. When I got in here, they decided to switch my treatment out for using a thin strip of gauze soaked in “Dakin’s solution”, (just saline with 5% bleach,) and then covering that with a dressing bandage.
Well, the wound got worse because it was constantly soaked, and the bedsore ended up all macerated, (basically the same thing that happens with trench foot,) and died. Then I talked the into going back to dry dressing, and they started using this tape that was very stiff when dry and packing that into the wound and then covering THAT with a dressing. That helped with the maceration, but irritated the inside of the wound and made the undermining, (where the hole is larger beneath the skin that at the surface,) worse. THEN after several more weeks, I got them to go back to using the aquacil, and… amazingly enough… even with these sucky mattresses, the wound was healing once again instead of getting worse.
That’s when the plastic surgeon, (Dr. “R”, who’d previously been adamant that I’d never heal from ANY surgery because I’d had radiation treatments 27 years ago,) decided that the best way to treat the bedsore was to debride it, and that’s when he turned a small hole with just a bit of undermining into bigger hole with more undermining. Until Monday, they’re just packing it with gauze and covering it with these pads that are like diapers in how much fluid they’ll absorb before becoming saturated and leaking through. So far, I’ve had two pair of my pajama bottoms end up with blood all over them, so the bleeding from the wound hasn’t settle down yet. (Again, I’m on blood thinners.)
What’s the logic behind all this stuff? It’s the VA, and they are entirely inconsistent in just about everything they do, but apparently Dr. “Q” gave these doctors a piece of his mind, (Dr. “E” said when he talked to Dr. “Q”, the latter told him he was impressed with me, I guess because I went in with good questions for him about the procedure, and a good knowledge of the problems I’m dealing with and what needs to be done to fix them,) because all the doctors who were dead set against my having any surgical repairs at all on these problems have had a total attitude change towards me. They’re no longer acting like I’m just some dumb schmuck who doesn’t know what he’s talking about to listening to me and, in the case of the plastic surgeon, deciding that cutting holes in me was the best way to fix this bedsore.
The downside of this surgery I had is that where the wound wasn’t hitting any areas where I can feel much, (my sensation is patchy from the chest down,) it hurts quite a bit, so right now I’m on my max doses of morphine and oxymoron’s and STILL haven’t been able to sleep more than a few hours since the surgery. Past experience with the wound-vac tells me that once they put that on, the pain will go down quite a bit.
Anyway, that’s where things stand right now. I’ve now had 13 surgeries over the past 30 years, (this one was minor, the rest major,) and the partial hemipelvectomy will be #14. And why??? ALL because way back when I was first injured, it took them 6 years to finally do the proper tests that revealed there was a bone chip that had been knocked loose inside my spinal canal when the bullet hit the vertebra. And THEN, after having lost all the movement I’d regained starting within the first week of my injury after being put on military transport planes to fly me to different hospitals with that bone chip in there, (now I have a TINY bit of movement in my left foot, but nothing useful,) they refused to cut the tendons in my legs, (too DRASTIC they said,) when they were dislocating my hips and knees until after they’d destroyed my left hip socket and they had to cut the ball off the femur and leave it permanently dislocated, which ended up with the femur pulling up and creating an area vulnerable to pressure so when I rolled onto my left hip in my sleep, it created that bedsore that wouldn’t heal and then it took the VA more than six years to actually do surgery to fix THAT, (and then only after the infection went septic and they HAD to operate instead of just sending me home like they wanted to.) And of course, amputating my left leg was, again, too drastic, and so when Dr. “W”, head of ortho operated, he missed some of the infection, and it got into my pelvis like I’d wanted to have the leg amputated to avoid, and so here we are!
Ain’t government health care just WONDERFUL! Dr. “Q”, the ortho surgeon down at UNMH, is the FIRST surgeon I’ve dealt with who has the same philosophy as I do, which is to not play tiddlywinks with is kind of stuff, but do what will eventually need to be done anyway BEFORE not doing it causes major damage and requires much MORE drastic surgeries than if they’d just done what I’d asked them to do in the first place. Of course, he’s a civilian doctor, so that explains the difference in attitudes, but going to him for an independent second opinion is probably the smartest move I’ve made in the 30 years that I’ve been dealing with the bullshit I get from doctor’s at the VA.
The thing is that there’s basically two types of doctor’s in the VA system. There are the ones that are very, VERY good, but forego the higher pay they could get in private practice because they truly care about giving veterans the best care they can give, and very, VERY bad ones who couldn’t survive in private practice because they’d get sued out of existence for malpractice.
On a final note, when I was first injured, you couldn’t sue the VA for malpractice. I found out about a month ago that now, you CAN sue, and depending on how much of my pelvis Dr. “Q” ends up having to take out, and how that affects my daily living, I’m seriously considering suing the VA over this screwup where they refused to amputate my leg to prevent the infection from getting into my pelvis. There’s a two year window to file a lawsuit, so I have about 14 more months to decide whether to do that or not. Suing people has always been something distasteful to me, but in this case, if Dr. “Q” has to take out more of my pelvis than I think he will, and my quality of life is seriously affected because of having to have part of my pelvis taken out, I’m strongly considering it.
The thing is that when suing the VA, a jury trial isn’t possible, and instead it goes in front of a federal judge, who tend to give smaller awards for damages, but on the plus side, the cases don’t go through years and years of appeals before any award is given. One fellow in the hospital, (who likes to hang around the Spinal Cord Injury ward for some reason,) had a small black sore appear on his leg one day, and when he came in to see a doctor about it and was told it was nothing and was sent home. It got worse, and all the doctor’s did was to put dressings on it and send him back home. It turned out to be a staph infection, and by the time they were done blowing him off, he had to have his left leg amputated just below the knee. The VA offered him a $40,000 settlement, which he refused, (he was in good health all around before this,) and is now suing for a couple of million plus. He probably won’t get the full amount, but the odds are very high that he’ll get far more than the original settlement offer.
One thing that’s in my corner on that is that the patient advocate here at the hospital just happens to be a member of the same Marine Corps League chapter I’m a member of, (he was a Navy Corpsman during Vietnam,) and has been following my misadventures with the VA from the beginning of last year’s garbage where they wanted to discharge me with an active infection that, had I been at home when it went septic, would have ended up killing me because I wouldn’t have recognized the symptoms until it was too late. So… he’s familiar with this whole thing and can guide me through the process, though if I do file a suit against the VA, once I put in the initial paperwork, he’s out of the loop entirely and it becomes a fight between my lawyers and the VA’s lawyers.
He gave me a business card from his lawyers and they don’t charge a dime unless they win the case, and then take the 30% or so as their fee. Suing the VA for malpractice is ALL these guys do, and they have their own team of medical experts to tell them if a case is winnable or not, but I won’t end up stuck with big legal fees just to get the process started if I go that route.
Again, sorry for the delay on this update, but besides things being in a sort of limbo for awhile, and nothing really new to report until a few days ago when the VA approved the payment to UNMH for this surgery, I’ve had a horrendous time for the past several weeks with allergies from one of the trees putting out record amounts of pollen and I had not only the runny nose and sinus congestion, but really bad chest congestion as well, and besides not feeling good, between that and the energy this infection sucks out of me, I had NO energy to do much of anything. They even had me on oxygen whenever I was in bed, (most of the time,) and getting regular nebulizer treatments to try to open up the passages in my lungs. My oxygen saturation, which is normally around 95% dropped to 80% and sometimes even lower.
So, except for the delays due to government red tape, things are still clicking along my way, and if things go as well as possible, after this surgery, I’ll be able to get off all the narcotic drugs I’m on for spasms and pain now, and see if I can’t get the FAA to approve my medical again and get my pilot’s license renewed. If THAT happens, once I get my debts paid off and trade my car in for a truck, (I have a new wheelchair with power assist wheels that’s too heavy to haul into the car, so I’m going to get a Ford F-150 4X4 truck with the extended cab and the VA will put in a lift that picks the chair up and puts it behind the seat,) then I start saving up to buy myself a Cessna 177 Cardinal airplane. If it doesn’t, and it’s kind of a longshot, then once everything’s paid off and I’ve got my truck, I’ll be saving up to build a house.
If I get a 177 Cardinal with long range tanks, (or have them installed if they’re not already there,) then it has enough range for me to be able to fly from Florida to Puerto Rico to visit my step daughter and friends I’ve got out there whenever I want, and NOT have to go through the feel-up pat-downs you have to go through when you fly commercial these days. Then I can get back to traveling here and there when the mood strikes me, and won’t have to have a lineman take apart and stow my wheelchair in the baggage compartment of the Cessna 172’s like I always did before when I was having so much fun flying here and there to visit friends. (The 172 has a short door and wing strut that won’t allow it to open past about 45 degrees, while the 177, besides being a bit of a higher performance plane, has a door that’s about four feet long and no wing strut so the door will open up to about 80 degrees, which will allow me to put the wheelchair in behind the seat like I do with my car.)
With the way everything's been suddenly clicking my way on all this stuff, I'm really hoping for a very positive outcome on this surgery, and a return to an active lifestyle like I was able to enjoy before I got that stupid bedsore that the doctor's, both out in Puerto Rico and here, just didn't want to treat. One thing I'm sure of is that all the prayers that have gone up for me from y'all have helped turn this situation around, so please keep 'em coming! :-)
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