Beats The Alternative

 I am still alive.

While that might not have been a question you asked, I was a bit worried late last week.

And now, the saga of the Forest Gump diagnosis.  Yes, Stupid Is As Stupid Does.  

A couple of months ago, I noticed a definite itching on the space above my fourth toe on my right foot.  I am in no way an athlete, so I did not initially suspect athlete's foot.  I thought Cellulitis, Osteomyelitis, or some other horrible foot-friendly minor incident which would, as these things do, tend to go away with soap and water and ... well, overall foot care.  Um, duh.

Because I'm me, and a pretty charter member of the Gump Club, I figured I could resolve it myself.  And when I finally gave up and gave myself a birthday present by going to Urgent Care to have it diagnosed and treated, well, that was a gigantic mistake.

I will state right here that I know damned well that our health care system is pretty well over-abused in this pandemic time.  Aside from the huge number of sick people who are sick because they don't want to get a vaccine that prevents that particular illness, it's fall, and apparently that's something that tends to go along with early holiday shopping for some folks.  Not I, I expect, but it is as it is and what it is.  And so when I did not receive any sort of followup information after the prescription of an antibiotic, I presumed - as idiots tend to do - that I would be fine.  

And I was ... well, not doing great.  I had some concerns after I failed to hear from the urgent care folks, and so I proceeded to do my thing.  gentle washing with soap and water, application of various athlete foot creams, and things ... varied.  Some days it felt well.  Other days it felt terrible.  As I later characterized it, my foot felt fine most of the day, especially when I was keeping pressure on the bottom of the foot.  Yes, that's right.  The infection was on top of the foot, the pressure was on the bottom, and the foot felt fine.  When pressure was released from the bottom of the foot, the pain would range from a 2 to perhaps a 6.  

Until I went to bed.  And when you lack any distractions or other coping methodologies, a pain of 6 on a 1-10 scale can become about a 600 when you're awakened from a deep sleep with a twinge.

And on Tuesday, 10/26, I went to bed with a sore foot.  I took my Tylenol and my benadryl, and laid down.  I laid there in bed, trying to sleep, for about two hours.  When my wife came down to bed, I was pulling on my sweat pants and getting ready to take myself to the Emergency Room.  She herself had spent two nights in-patient with a recent A-fib attack which was quickly corrected, so I presumed stupidly that I should be able to correct a problem I'd fiddled with and tolerated for two months in a few minutes.

Yeah, you can see where the whole Gump thing fits.  I got to the Emergency Room slightly before midnight on a Tuesday night.  Tuesdays are fairly quiet, I guess, because aside from the staff, Ann and I had our pick of chairs, except for one other, in the waiting room.  Only one other patient.

And as one might expect, I managed to get myself comfortably seated just about the same time they called me back in the exam room.  And after the usual vital statistics, I was ... invited back to the emergency room.  There, the same nurse who had been my wife's primary caretaker the week before did a double take as we walked in, and asked what we were doing back.  I said "my turn".  

I was shown into the room, the foot was examined, and then they sent for doctors.  Swabs and sticks and pokes were then done, and I was informed that it looked like I might need to be seen by a foot specialist.  Well, OK, I would have thought infectious disease people might want me on a petri dish for fun, but I am what I am, I guess.

And then I was informed by the hospitalist - that is, a doctor who sees only patients in the hospital.  If you're looking for your regular doctor, nope, they don't come see you any more, you're working with people who only see patients who can't get away, and wear those sweeping, stylish gowns.  Yeah, they haven't improved in 13 years.

But I was left to stew for a few hours after I was informed that, at that moment, a standard hospital room was not available, I would need to cool my heels in the emergency room, taking up precious ER space, until they decided what the next step was.  Then this entirely too-young doctor came in, told me she was a surgeon podiatrist, and I would be getting the full treatment - they'd need to check to see what I was attempting to grow inside, and then they would correct whatever it might be, if possible.

Then the scary shit started.  The doctors came back and said the infection looked bad, they needed to get an MRI, the X-Ray was inconclusive, and they would need to determine if any infection had gotten to the bone.  I joked that it was apparent to me that the stupidity had gone deeply into the bone between my ears.  The doctors did not seem to get the joke.  So my future stand-up career never even qualified for life support.  It died right there.  As it usually does.

But after the MRI, the surgeon returned and informed me that she was confident they could drain the abscess which had apparently formed within my foot, causing the increasing level of pain I was experiencing.  And as that was not a huge concern for her, her major worry was the infection, she would be taking samples and testing to see what might be done to fix that part.

Happy Hump Day.  After almost 12 hours in the ER, I was rolled into the pre-op suite, prepared, disrobed all the way down to nothing but the gown, and then thought to inform my wife what was about to happen.  So I did.  Then they rolled me into the operating room.  I don't think I managed a full look all the way around the room before the lights went out and I became awake and aware the lights had gone down a bit.

All done.  I was informed the surgery had gone well, the presumed abscess was actually a hematoma.  As this spell checker does not like that spelling I expect I'll not be able to find it in google, so done is done.  The good news is that they felt good that the infection had been removed, my foot was heavily swathed, and I'd be rolled upstairs to a room.  Same floor my wife had been in.

And when I got there, I got to figure out how to get comfortable in the hospital bed.  I had been on the original gurney from the ER through to the X-ray, the MRI, then surgery.  At some point, they moved me into a standard bed, and a nice young man wheeled my hind parts into the room.  And there I had a window overlooking a fair amount of mechanical gear on a roof, and a nice northern-sky view.  

In their infinite wisdome, the hospital's television program offerings were ... well, let's just say that if there was some program on a network where you'd cringe if you were in it, or just be appalled in general at the overall behavior, that was about 95% of the available "entertainment".  As I was not overwhelmingly tired, I watched a lot of crap.

And when it came time for meals, well, I skimped.  I know, I know, mother, three squares a day.  The first day I had a roast beef sandwich smuggled in by my wife for my dinner.  I'd had a grilled cheese sandwich for dinner the night before, and it was still working it's way in-system.  And thanks to the miracle of modern infusion medicine, I had onloaded several grams of multiple antibiotics, and a literal shitload of saline.  

Which is where it gets really strange when you drink less than a half a styrofoam cup of water a day and find yourself having to pee four or five times a day when you maybe offload two or three times after consuming some two liters of liquid (most of it water, about half of one liter diet Mountain Dew), that's just strange.

But after the first day, I found confronting the build-your-own Omlet choice (per the actual menu spelling) was utterly disheartening.  I tried a cheeseburger, I had a cheese and chicken quesadilla, a cheese and pork quesadilla, and a bacon cheeseburger.  I also thought to veer into the "dinner entre" section of the menu.  My diet was noted as "moderate carb restrictions".  So I figured I would behave.  With the cheeseburger I tried the black beans.  Would have preferred baked beans, but that wasn't an option.  And the black beans had been prepared simply - that is, they emptied and drained a can of black beans, tossed them on top of a small bed of chopped onions which had landed in a lukewarm pan, added cilantro, which to me is right up there with eating Dial Soap, so no thanks, but I needed the fiber.

Of course, I looked long and hard at the dinner entree section, and decided a safe bet might be some roasted turkey.  I squeezed hard, avoided the mashed potatoes because I'm diabetic, you know, but we were able to eek out enough carb space to add a piece of whole wheat bread, and a chocolate cookie.  Or we might have done so, had they had any left in the kitchen.  Nope, none for me.  But I did have enough room for a chocolate brownie.  

Which was not even close to making up for the alleged turkey which arrived.  Now, I'm an adult, I should know if Gravy is not specified, it's probably it's own side dish.  I failed to ask about that.  So when I took the cloche off the plate and discovered this kidney-slice-shaped slab of ... well, shoe leather cooked for some time in a pressure cooker might have accomplished the same thing, but it is what it is, I suppose.  Given what I had done to myself, I'm sure that a steamrolled flat slice of something that may have once been referred to as a species of fowl was utterly appropriate.  And well deserved.  So that will most likely not larn me, but we'll get to that a little bit later.

Which was a Sara Lee chocolate frosted brownie.  Whoo hoo.  I did get my cookie the next day with the pork quesadilla which was rather nasty.  But again, the dread cilantro destroyed the dish for me.  I should know better by now.  

So yeah, that's the food highlight.  You will certainly note that there's not enough meals there to cover three squares over five and a half days, and yeah, I did not eat much.  I ate some crackers which were delivered early on in my stay, and I was cautious in working through them.

Then there was Thursday's "Foot Highlight".  In my last hospital stay in 2008, I was utterly unaware of the size of the wound in my leg until the first dressing change, some week after the initial installation of the wound vacuum, which was four days after I was released after surgery to gouge out all of the cellulitis which had grown in my left shin.  There was the "First Pee" on Wednesday, where I promised to not put weight on the front portion of my bad foot, and did not.  However, the appalling amount of blood on the bathroom floor once I finished the deed was concerning.

Which was fucking minor compared to the Thursday Podiatrist visit.  My surgeon came back and wished to inspect her work.  Pro tip here - if the surgeon wants to see their work, beat holy hell out of that nurse call button and tell your nurse the surgeon is about to go poking in areas they recently toured with the assistance of a trained anesthesiologist professional - and I want to rather proudly note that I spelled, off the top of my head, without consulting anything, the word anesthesiologist.  Score one there.

So in detail, the surgeon cut away the ace bandages and somewhat bloody gauze.  I looked at the foot, expecting to see impressive embroidery or at least neat stitch work.  Nyet.  Not a hope in hell.  The hole between my third and fourth toes is not clean through, but about 3/4 of an inch deep.  Mind you, my foot isn't much thicker there, but due to the angle of the hole, well, when you've got a hole the size of a pencil in your foot and someone starts poking and rubbing gauze, well, pain on the 1-10 scale quickly flies out the window, and is replaced with every evil word you've ever crossed paths with until you literally lose consciousness from the pain.  

Yeah, not proud, I did.  And then, about 90 minutes later, the "wound vac nurse" came in.  I do consider it a small badge of honor that I did not drop and run (mind you, I was still sans underpants, wearing only a hospital gown, untied, and a pair of hospital non-skid socks that had been knitted up for the elephants over at the zoo.  Yeah, they were that large.  I could have put both my feet in one, and could have been joined by two or three others, that is, those who were non-squeamish and willing to guarantee they would not step on my right foot at all).  Though I did have the presence of mind to hit that nurse call button and indicate to the responding nurse in polite, respectful terms (truthfully, here) that if another person intended to lay hands upon my feet, I would be needing some form of painkiller, or I'd need to find a way to crawl out of the hospital.

And the nice nurse listened and dosed me with - spelling is a total guess here - Dilauded - which worked.  And I later learned that it's a step UP on the pain killer scale from the whole Oxy family, so ... yikes.  I am not going to find any sort of supply of that medication, I am just thankful it exists.  And it was on-board, as they say, when the very talented wound vac nurse managed to spackle and duct-tape my foot into a situation where the only exit for anything - including bits of me - was through the Playmate-cooler sized vacuum unit sitting on the floor next to my bed.  Which occasionally farted just to make sure I was still awake.  

But then we started to talk about that nice word - discharge.  First, the holdup was the infectious disease diagnosis.  One germ had been identified and it was responding poorly (I always wonder why they say an infection "responds well" to an antibiotic.  I think that responding well would indicate it would be thriving, and I'd really rather hear it scream and try to climb out of the dish before dying in fire, but I suppose that's a bit extreme within a human body).  The other germ which they'd identified had three potential names.  The first was "plain old staph" - which was scary, but did not seem to concern the doctor.  The second was "resistant staph" which very nearly scared the shit out of me, because that stuff isn't any fun.  Then she threatened to go full nuclear with "Mersa" - no relation to the young lady in that Scottish-themed Disney movie, but actually spelled "MRSA" - which is one of those "eat you out of house and home, laugh at 90% of the medication that would destroy other infections".  Yeah.

But the first bit of good news was that the infection had not gotten into the bone, I wasn't that stupid.  But as things progressed, we discussed "a boot" and a cane to assist me in movement, and other things.  Then the footwear arrived.

It is not utterly left field to note that this past Halloween marked the 30th Anniversary of our Halloween Blizzard.  I was a grown adult when that damned thing hit, out of nowhere, in 1991.  My wife and I had spent much of the weekend prior preparing hand-filled ravioli - meat, cheese, and both - for our Halloween/First Anniversary dinner with friends that would happen on Halloween.

Yeah, that.  I was working late that Thursday, which was Halloween.  I had gone out to my vehicle at 5:30 pm and removed about ten inches of snow that had accumulated and not been blown off the vehicle.  I started warming my car up, since I knew it had been cold all day and I'd need good, clear windows, and hadn't yet gotten a new window-scraper snow brush for the year.  The previous year's model was rather dinged and not very helpful.

But I noticed that traffic was literally at a complete standstill on the freeway in front of my then-employer's offices.  When the clock hit 6 pm, I called home to let my wife know, as she had been done at 4:30 pm and usually was home by 5, that I'd be on my way for a slow commute.  She wasn't home.  I left a message.

Then got into my car, and drove the literal eight miles down the freeway from my employer's office to my apartment building.  That's right.  I drove down a frontage road, into an on-ramp onto the freeway, stayed in the same lane all the way down the freeway, and took the fourth exit across the river, followed the loop up to the street, crossed the freeway, took the first right after the freeway, and took that all the way to the dead end parking lot of our apartment building of the time.  And I had the ... well, good sense to back into the open parking spot I found so I could be able to get out of it the following morning.  Silly mortal.  I didn't get out of that spot for 3 days.

But that was 1991.  I noted to the nurse who was assisting with the potential medical equipment need that a boot might be a good choice as we were now well and truly into a period where, if I was trying to walk with some flip-flop thing, we'd get a good foot of snow. 

And so I got sent home with a sort of wrap-around sandal and a boot.  The sandal has an open toe, some half-height sides of velcro loop, two or three velcro bands which are unattached at both ends, and connect to the rest of the thing only by the hooks into the loops, but a firm, solid sole that does not bend on any weight I put on it.  And a fuzzy, furry boot that is too small for my foot and has literally no sole at all - it's just fabric with some studded rubber dots to make it allegedly non-skid.  So you know what I'm using.

After I passed the walking and stairs test with physical fitness, I was informed that I might be ready to go, all that was needed was the final diagnosis and the completed arrangements for home nursing.  Huh?  Yeah, I'm one of those. The nurse needs to come see me three days a week to change my dressing.  Thirteen years ago I was an adult who was expected to get my butt back and forth to the doctor's office every 5-12 days for dressing and sponge changes.

Apparently that was not enough for some, because I now needed a nurse.  And that was going to require someone to arrange a service, and insure that someone could actually see me.  And those folks don't work weekends. 

But we were still waiting on the last medication.  To spare you the agony I had, it came back, eventually, as good old basic staph, or something that would respond to an antibiotic.  So once we had all of that sorted, I opened my mouth about painkillers for when the visiting nurse came.  If she was going to be poking inside my foot, I wanted something to insure I didn't pass out.  And boy, they do a good thorough double-check on that.  But once that was cleared through, I was ... released.

And tomorrow, I get my first dressing change.  I hope it all goes well.  And then we roll slowly into the next day.  And I'm working tomorrow, because I sure as hell do not want to spend any more time stuck in the same position in a hospital bed.  Any more.