Carrying On - (caution, medical details)
I look back on my last entry, posted in October, mostly written in August. Lots of dark stuff, Mom not doing well, Dad dying. 2012 was not the best year. This one didn't start so well either but we are surviving. We are doing quite well in fact.
Jim and I took a great vacation in October, spending a week at a B&B cottage on a farm full of pet goats, a potbellied pig, dogs, and chickens. Great fun. We mostly relaxed, worked on writing, gave treats to the animals who became fond of us, did some great cooking and eating, smoked ourselves well with the leaky fireplace but otherwise loved the pine paneled house we were in. We were in the Western region of Wisconsin in the Driftless area, where the land is dramatically hilly. Our farm was surrounded by Amish farms so it was very quiet. A nice break from being in town.
On the Sunday after we returned home, Jim showed me a spot on the top of his foot that was getting red. There was also a small scab on the foot that had been there awhile. The next morning it looked much worse so I dropped Jim off at the emergency room before work. There they put him on IV antibiotics but didn't admit him. I drove him home and went back to work. Mid-afternoon he called saying it was getting worse, he had a fever, and his foot was hurting pretty badly so he was going back to the hospital in a taxi. I met him there. After about 5 hours when he was getting antibiotics and doses of dilauded (a morphine substitute) he was finally admitted to the hospital.
He stayed in the hospital for 8 nights during which time 3 wounds had opened on his foot, two of them looking terrible. The fever went down eventually, and they found a way of dealing with the pain (eventually) and the wounds stopped getting worse. An MRI of the foot didn't show any bone infection so they sent him home. I went off to Minneapolis for a much anticipated weekend with my friends. (We had a wonderful time!) When I got back my Mom had just broken her arm and I drove her home from urgent care and tucked her in. (Alex took her to the Urgent care, after a several phone calls. Jim couldn't drive.) Two days later, Jim was back in the hospital. The oral antibiotics didn't work for him because the circulation in his right leg was very bad. This time he was there for 5 days getting the antibiotics working again. They also did an angiogram and inserted a stent in his leg a few inches below the knee where a major artery was clogged. Another MRI was done--no bone infection found.
After that he had IV antibiotics at home. I learned to bandage his foot every day and Jim did his own IVs. Once he was off IVs in December he went back to work half time. He wasn't allowed to use his foot more than a tiny bit so he got around on a knee scooter (think "scooter" raised to knee level with a big pad on it.) Meanwhile day by day we watched for improvements in the two wounds on his foot that were about an inch in diameter. Not much improvement. He went to a Wound specialist every week and we varied our techniques for wrapping it, using various scab dissolving materials (that also involved wipes to protect skin we didn't want to dissolve.) A big fear was that the wound went down all the way to the tendon, which, I'm pretty sure one of them did. We didn't see much improvement but for weeks, it didn't seem to be getting worse. But then it did.
Patches of infection showed up on the bottom of his foot. Inflammation at the instep, pus filled scabs near the toes. Lots of drainage from the top of the foot. On Friday, January 4th the wound specialist ordered tests. Another scan of the arteries, another MRI, blood tests for bacteria. That weekend, Jim was gloomy. I was busy reorganizing my office and ignoring the other housework except for some cooking and a bit of dish washing, so the house was dusty and a bit messy. (I made progress on my office however!)
Monday we went back to the wound specialist. We were in the office only minutes before she came in along with the surgeon who had done Jim's angioplasty. Minutes later we realized that Jim would lose his foot. The MRI showed that there was considerable infection in the bones of his foot. We had a choice to remove the whole foot and get rid of the infection or to remove part of the foot. Due to the damage to the capillaries in Jim's foot, the remaining foot would be very vulnerable to repeat infection and in the end he would have to lose it anyhow. The partial removal would require healing in a weak area and the outlook was essentially grim. Removing the foot would enable Jim to have healthy arteries in the part remaining.
So we drove to the hospital right then where they got him back on antibiotics with the surgery settled for Thursday morning. Now Jim has a healing incision on his leg. It looks more or less like a teddy bear foot. Not scary. No infection. He gets by with a wheelchair, and a walker (hops.) He can stand on one leg supporting himself on a counter in order to reach cupboards. He seems to be learning how to do everything he needs to.
To wrap up, Mom's arm healed although she hurt her back in a fall so we had numerous PT appointments. She's having increasing problems with speech and electronics are her enemy. Last week she survived a bout with a Norovirus (sweeps through assisted living centers like the plague.) Generally, though, she's still good company most of the time. I stopped to see her yesterday to drop off some muffins, milk, and bananas, and got her TV and radio working again. (One of those invisible black buttons on the TV had gotten pushed and the cord came out of the back of her radio.) I wish I could do these things for her daily. It would take her anxiety levels down a great deal.