Wednesday and Thursday, February 11 & 12, 2009

OK—here’s my update.

I continue to have intense body aches, a mild fever, dizzy/fainting spells, and an overall feeling of being a wet dishrag (+pain).  One moment, I can look at food and think it looks pretty good, and the next moment the near mention of food can make me want to lose my lunch.  I have hardly even thought about my ankle for the last few days (and thank goodness—it has been doing very well!).

In an effort to figure out what is going on, Dr. Jacobsen (the infectious disease doctor) is running a lot of tests on my blood. 

On Wednesday, they just went ahead and assumed that the PIC line was infected (the actual results will come back late Friday) and removed it.  I now have a temporary IV line in my lower arm that needs to be changed every other day.  They put me on yet another antibiotic (Cubicin) to kill off the bacteria in my blood from the PIC line.  If it turns out that the PIC line was not infected, they will take me off of the Cubicin.

Some blood results came back today (Thursday) and showed that my white blood cell count is very low.  On the up side, my other levels are a little low but in the normal range.  They now think that the Zosyn (the antibiotic that I have been on since the first day of my fall) is the cause of the low white blood cell count, and the chills and fever.  Therefore, I go back to Dr. Jacobsen’s office tomorrow to get a new IV line, take more blood cultures, and get a whole new supply of antibiotics that will fight the type of infection that was in my foot (but hopefully NOT have the fatigue/fever side effects).

It was nice to have a day today where I did not have to go anywhere.  My Mom just keeps filling me up with food and Gatorade, and my Dad has been working on making my wheelchair “external fixator accessible.”  He also went to DMV and got me a handicapped parking sticker good until 2012!  I am thinking that when I finally get better, EVERYONE is going to want to take me along to ball games, Publix, and wherever else the parking is impossible!

The Blanco family surprised us with two frozen deep-dish pizzas—delivered straight from Chicago!!  The pizza was wonderful and the dry ice in the box provided lots of entertainment for Doug and the girls.  Our house continues to be filled with wonderful food that is keeping me going.  Thanks to so many of you who have been helping us out! 

Elise and Annika came home on a Valentine’s Day high—their arms filled with notes, flowers, candy, and love.  Just when I thought everything was great, Annika expressed sad disappointment that I wasn’t there today for her V-day party where she read an essay that she written about when Doug and I met.  What to do.

I want to leave you with one last thought:  You know how people always say that being a parent is thankless job??  Well, I found one even worse—being a caretaker.  My Mom, Dad, Doug, Sharon, and the girls were never really asked if they would be willing to drop everything to take care of me, but they did it because they had to.  And guess what . . . on average, the patient (that would be me) is quietly letting the caregiver know that they are doing a lousy job.  No kidding.  I try not to be ornery or needy or “short,” but between being extremely emotionally fragile, feeling totally lousy, and being unable to do a single thing for myself—I end up taking out my frustrations on the one person who is keeping me alive—my caretaker!!!  When I was in the bathroom at Dr. Jacobsen’s office, I was annoyed that my Mom kept knocking on the door to see if I was OK.  But guess what—I would have been annoyed if I had keeled over on the floor and she failed to check on me!  Doug is killing himself to find food that doesn’t make me crazy, and instead of saying thank you, I get all annoyed that he is putting food in my face that is making me feel sick.  It absolutely goes against all logic or “survival of the fittest” thinking that one would bite the hand that is feeding me.

So . . . Mom, Doug, Dad, Sharon, Annika, and Elise—

I am in awe of the fact that you have served, served, and served—without expecting anything in return.  I am so deeply sorry for the times that I let my neediness overwhelm me and I treat you with an attitude anything less than “extremely grateful.”  In the end, I will be healed, and it will be because God gave you to me as His angels to set your own wants and needs aside and simply serve a very flawed and annoying patient.  I love you so much, Anne/Mom

Wednesday morning, February 11, 2009

Today is one of those mornings where the sight of the sun signals an end to the struggles of the night, and provides hope that the light of day will bring about some healing and peace.

Yesterday was pretty rough.  Although I woke up feeling “with it,” I had a series of near-fainting spells throughout the day.  Luckily, my home healthcare nurse had just stressed the importance of attaching my cell phone to my walker so that I could call for help at any time.  So when I felt myself slipping away yesterday morning in the bathroom, I was able to call my mom and she came within 2 minutes to help me.

I had my first appointment at the Jackson South Wound Care Clinic yesterday afternoon to meet with Dr. Carbonell.  Mom pumped me up with enough food and Gatorade to summon enough energy to get into the car and handle the drive to the clinic.  Sure enough, even though we had a mapquest map and directions from the clinic, we (of course) could not find the place.  When we finally did, we were 10 minutes late.  Mom parked illegally and went inside to find a wheelchair.  She immerged with a wheelchair so wide that she had to partially fold it to get it out the door of the building to the car.  You can only imagine, then, how easy it was to get me back inside when sitting in it!  Sitting in this huge wheelchair while holding a VAC, antibiotic drip, my walker, purse, med bag, etc. while keeping my leg up (on my own strength since no wheelchair is designed to accommodate an external fixator)—and then trying to figure out how to get through the narrow door . . . Mom and I decided we had better laugh before we started crying.

Mom and I ended up sitting in a small waiting room for an hour with at least ten of Dr. Carbonell’s patients.  Some were wearing VACS, some wore interesting orthopedic shoes, some had taken the bus from across town just to get some meds, and some were recovering from recent skin grafts, while others were there to get a dressing change.  Most were diabetic and spoke of the ridiculous years of running from this specialist to that specialist—trying to find a doctor who could actually care for their needs.  All of them spoke of Dr. Carbonell as if he was a miracle worker.

Long story short, Dr. Carbonell was thrilled at the sight of my wound.  It really looks great.  He asked his assistant to begin work of getting approval for a skin graft, and signed paperwork to enable me to get a handicapped sticker for whoever is driving me around. 

He and Dr. Jacobsen (my infectious disease doctor) suspect that my night fever is a sign that my PIC line is infected.  They also think that my fainting spells are a sign that my blood levels are off.

Sweet Dr. Jacobsen gave me his personal cell phone number so that I could call him if I got another fever (last night).  Sure enough, by 11:00 last night, I had chills, deep body aches, and a 100.6 fever.  Dr. Jacobsen told me to plan on going in to his office today, getting blood work done, getting the PIC line removed, and using some more antibiotics to kill the bacteria in the blood.

Annika is so worried that I will end up in the hospital again.  She is trying so hard to “go with the flow,” but I really think that she just needs s a few day of “normal.”  Bless her heart.  It just seems like every day has yet another issue that we are dealing with.  I think this is what Dr. Jacobsen is talking about when he says that the next few months will be a “long haul.”

Overall—I almost feel embarrassed that I am so blessed.  Dr. Carbonell arranged that I would be his first patient next week at the wound care center so that I won’t have to wait in the lobby.  Dr. Jacobsen is encouraging me to use his personal cell phone number if I have any weird symptoms.  Unlike the patients I met yesterday, God placed the most talented doctors in my life the FIRST time around—not after several failed experiences with other doctors.  In light of these blessings, the least I can do is joyfully “go with the flow” and patiently suffer through the pain and struggles of getting “better.”

Thanks to Penny Lyn for the awesome exercise mat, my Mom for putting in some long hours, and to all of you who have been filling my house with fruit, meals, cookies, brownies, sweet and encouraging things for the girls, and healthy meals for my family!  You are all a blessing.

Love to you all—

Anne

Friday afternoon - Monday, February 6-9, 2009

Hello, my friends.  It seems weird that I have not written to you for a while.  I have now been home for three

 days and feel like I have started an entirely new journey.  Having spent three weeks in the hospital, I had--without realizing--become accustomed to certain routines, limitations, and expectations.  Now that I am home, I am having to start all over with a . . .

• new environment (how am I supposed to get on that toilet?!),
• new people (well, hello, Nurse Douglas!),
  
• new scares (who do I call at 3 a.m. when I have a fever??),
• new equipment (why is my mini-VAC making all those noises??),
  
• new questions (is it OK that my toes are turning purple??),
  
• new challenges (how do I sit up in bed when we have used every pillow in the house to prop up my foot??),
  
• and a new set of joys (What?? I get to cuddle with my family in bed??).

Having said that, I will give you a quick run-down on my life since Friday morning . . .

Friday, February 6, 2009

After sharing the amazing notes from Ms. McCoy’s class with you, I expected to live out the rest of the day in eager anticipation of my big return to my abode.  In reality, it felt like all of the positive thoughts that had been carrying me through the prior week were just the labored clicks of a roller coaster, slowly ascending up to the peak of the track before the big, scary, heart-in-your-mouth DROP. 

Since the first day of my accident, I have found great comfort in knowing what this is NOT . . . I am not paralyzed.  I can speak.  I can move.  I am alive.  I can continue to be a good mom and wife.  I can teach.  I am alive.

And if everything goes wrong, the worst that will happen is that I will have a prosthetic foot or undergo an ankle fusion.  I can live with that.

However, as the discharge papers were being prepared, I came face to face with something that I really did not want to think about . . . what IS. 

I was reading things like,

• “Patient has a very complex, limb-threatening injury, fracture, and deep infection that will require multiple treatment modalities and surgeries.” 
  
• “After the procedure, I discussed with the patient’s husband the significance of the type of injury that she has.  It is unlikely that this patient will have normal functioning after sustaining an injury such as this.”
  
• My most trusted resident’s starting answering questions that I really had not wanted to ask,
  
• “No, the cartilage on your talus bone is gone.”
  
• “No, you can not grow it back, or use artificial or cadaver cartilage.”
  
• “Yes, no matter how well we rebuild your ankle, you will always be bone on bone.”  “You will most likely develop arthritis within a year or two and will find it painful to walk.”
• “Your best bet would be to get a ankle fusion where the entire ankle is fused into a fixed position.”

All of a sudden I was imagining myself at the beginning of next school year . . .

Am I in a wheelchair?  Do I use a cane?  Do I limp?  Am I living in constant pain?  Can I go to the beach and walk on sand?  Can I walk with everyone else when exploring a new town or site on a vacation?  Do I have to wear a weird shoe?  Can I drive?  Am I a burden?  Do I hold everyone else back?  Do we begin to talk about who Mom was “before the accident?”

By about 3:30 p.m., my genuinely positive, can-do spirit was broken.  I was scared to leave the hospital for fear that I wasn’t going to be able to take care of all of my tenuous issues.  I felt disgusting with a VAC tube leading out of me with gook, an IV line coming into my arm, a hairdo testing the limits of what is socially-acceptable, and the undeniable recognition that I just might be wearing my open-backed gown for the rest of my life because it was the only thing that would fit over my external fixator!  And one more thing . . . I was going to throw my IV stand at the next uninformed student nurse who walked in and said, “Woowww. . . that looks really bad.  What’dga do?” or “Oh, don’t worry—You’ll be fine!!!!!”

When my Mom came at about 4:00, I told her to shut the door, pull the curtain, and stand guard by the door.  I walked into the bathroom, sat down, rested my head on my walker, and sobbed.  I sobbed and sobbed and sobbed.

And for those few moments, I allowed myself to stop being positive.  To stop thinking the best thoughts.  To stop putting my best foot forward.  And to just see it for what it was . . .

That falling off a ladder, suffering a catastrophic injury, facing a world of unknowns, and wondering if you are going to be a burden to your family for the rest of your life really, really, really STINKS.

 

Friday night – Monday, February 6-9, 2009

OK—Don’t worry.  By the time I left the hospital around 6:00 I was ready to take on the world one day at a time.  I wasn’t going to take on the scary unknown.  I would just rest in knowing that God continues to have an amazing plan for me.  I was glad that I was able to release a little steam/pressure before I left the hospital so that I could

 face the new challenges at home with renewed energy.

In a nutshell, we are figuring out where I hang out, how to manage my medications, how to keep me safe around the house, how to manage a few hours of uninterrupted sleep, how to get Doug some time alone to work at school, how to support the girls and talk through their feelings, and how to create a household that seems pretty “normal.”

My home healthcare nurse, Fiona, came for the first time on Sunday and changed my VAC.  She is a school nurse over at Calusa Elementary, is proud to be from Jamaica, has one teenage son, and takes care of a few patients during the evenings and weekends as an extra job.   Dr. Carbonell’s residents and I had made a video explaining some of the special issues with my ankle.  It was obvious that our little video was slightly patronizing in light of her amazing skills.  She knew exactly how to care for my wound and had my situation figured out in no time flat.  She will come to our house now on Thursday night and on Saturday.

Although I have been taking it REALLY SLOW these first few days, we have still had a few minor scares.  The first night I was home, my foot swelled up like a balloon again.  As Annika left for a soccer game on Saturday morning, she was convinced that I would be back in the hospital again by the time she got home.  Luckily, the doctor told me to stay off of it for a few days and elevate it to the sky.  Since then it has looked good.

Also, for the last two nights, I have suddenly felt incredible chills and body aches all over my body.  I run a fever of 100.3 for a few hours and then it goes back down.  Seeing as it is happening again tonight, I will be sure to call the infectious disease doctor in the morning.  We have learned not to react to these setbacks—but to just see them as bumps in the road that we will deal with soon enough. 

THE ABSOLUTE PLEASURE OF LEAVING THE HOSPITAL IS BEING ABLE TO SPEND TIME WITH MY FAMILY! 

My Mom has been sewing cute little external fixator “socks” to keep my foot covered.  She has also made about eighteen trips to Sports Authority to find the perfect sportswear that fits over a gigantic foot. 

Elise has become my little nurse who LOVES reminding me to take my medicine and even takes part in giving me my antibiotic injections!  If I ask her to get something for me, she runs to get it and returns saying, “Now what?!?!?!?!” 

Annika has this incredible ability to sense when I am thirsty, cold, or uncomfortable.  I took this picture right after she said, “Mom—your foot looks cold.  I am going to put a sock on it.”  My favorite is when she slathers lotion on my leg. 

And then there is Douglas.  Dear Douglas who is doing laundry, putting together healthy meals, managing homework and bedtimes, responding with concern to every little sigh or moan that leaves my mouth, keeping calm during setbacks, getting dressed up for the Father-Daughter Dance, filling up my water glass, making sure thank you notes are written, figuring out a way to wash my hair in the tub, and keeping up with a full time job . . .

All while telling me over and over that he loves me so much, that he is so incredibly proud of me, and that he never would have married anyone else. 

What a man.

Tomorrow I head to the Jackson South Wound Care Center to meet with Dr. Carbonell.  I am excited/anxious for him to check out my wound and to see where we are headed next. 

Thank you so much for the amazing ways in which each of you have supported my precious family.  Even though I don’t always get to name you specifically by name, please know that the love and generosity that you have bestowed to our family has been indelibly written on our hearts.

With much love,

Anne

P.S. Do any of you have one of those things that you put behind your back in bed so that you can sit upright?  Also, I need a thin exercise mat to put on the floor so that I can do my exercises on our tile.  Any ideas?

Friday morning, February 6, 2009

I got the sweetest package of notes from Ms. McCoy’s class last night.  After reading some of the comments, you will easily see why I adore working with young children.  So precious . . . 

Dear Mrs. Heetderks,

• “I know that God is taking care of you and I don’t want you to forget that.”
  
•  “I have been praying and praying.  We all need Jesus’ healing every once and a while. I just wish that the 10 foot ladder was only one foot tall.”
• “Mr. Heetderks told us about you on January 27 and he almost cried.”
  
•  “You are the best art teacher in the whole world.  You taught me stuff that my brother doesn’t know and he is in 8^th grade.”
  
• “I prayed for you last night.  My family prayed for you and even my hamster prayed for you.”
  
• “You are really blessed.  My mom said that it is a miracle that you are alive.”

In addition to these sweet kids, I know that so many of you have been praying for my family and me.  Thank you for

 all of your words of encouragement. I hope to be sending my next update to you from my home.  Time will tell. 

Love to all--Anne

(The pictures show my students making their own Sistine Chapel by painting on the underside of our tables, and creating Michelangelo-inspired gesture drawings of their peers.)

Wednesday, February 4, 2009

“OK . . . don’t get excited.  Don’t react.  I have good news, but . . . the news could go bad at any second.  So again, don’t get excited.  But I do have good news.”

This is the general gist of what I heard today.  So I am going to pass my good news along to you—but remember . . . DON’T GET EXCITED! 

Good News: The most recent bacteria culture they took a few days ago came back negative.  We have finally beaten the gram-negative rod bacteria!  I can now go home late Friday (to my house—shocking!) and administer the antibiotics on my own for about the next two months. 

Doctor’s Voice of Reason:  This is a positive step but the bacteria can easily mutate and begin attacking my wound from a different angle.  I need to know that this is going to be a “long haul.”  I need to be on the constant lookout for new signs of infection.  I may also have problems (yeast infection, thrush, diarrhea, etc.) from killing off the “good” bacteria with the antibiotics.

Good News:  The wound is healing beautifully.  The VAC has encouraged a ton of new, healthy tissue that is full of bright, red blood (the first picture shows all the dead tissue from when I first got readmitted to the hospital, the second was from Monday, and the third was from today).  The new tissue is slowly covering the exposed metal hardware that they screwed into my bone.  If the tissue stays healthy and continues to “fill in” the wound, I will get a skin graft in a few weeks.

Doctor’s Voice of Reason:  Although the wound is looking good, there is small pocket below the wound that keeps filling up with gook.  We keep trying to get the VAC to suck it up, but the pocket is just a little too deep.  Hopefully, the home health nurse who will visit me every other day to change my VAC will be able to stay on top of removing the gook and keep it from getting infected.

Good News:  The wound is healing and we have the infection under control.

Doctor’s Voice of Reason:  If we can keep this up, the bone will have a good chance to stay alive and heal.  However, the fact still remains that the talus bone was badly broken, the cartilage was destroyed, and many essential parts of the talus bone are missing (left behind in my front yard and/or floating around in my ankle).  There will be a long road ahead as Dr. Carbonell rebuilds the talus bone and tries to get it to function properly.

OK—so I won’t get excited (well—maybe just a little).  But I will tell you one thing:  I look forward to step into my own house, eat with my family, sleep next to my sweet husband, cuddle with my precious girls, stroke our dog, smell fresh air, and boldly step into the next “leg” of my journey.  Thank you so much for coming along for the ride!  With much love--Anne

Tuesday, February 3, 2009

On a medical note . . . My infectious disease doctor added another type of antibiotic to my daily does of bacteria-killing meds that I am taking.  We will get test results on Thursday or Friday to see if we have managed to kill off the bacteria from the wound.  Time will tell. The VAC continues to suck out gook from my wound and the sponge will be changed tomorrow.  

On a personal note . . . It is funny how getting good news can allow you to come up for air, breathe a little, and get out from under the gravity of your situation for a while.  Today has been like that.  It was Student Nurse Tuesday today (I have been in the hospital so long now that I actually know the weekly work, meal, and activity schedule by heart) so I was asked to tell my story twelve million times to all of the student nurses.  Later, their supervisor came in to assess if they had asked me the correct questions, collected the appropriate data, and checked out every part of my body to make sure it was working (or “moving”) properly.  It was amazing how some students could make an instant connection—putting me at ease, anticipating needs, offering genuine encouragement, etc.--while others were essentially “going through the motions.” 

As one who is now in the constant care of nurses and doctors—I get what it is to be on the receiving end of someone who enjoys what they do and desires to do it well.  Nurse Cam remembers to bring me orange jello and saltine crackers whenever she gives me my Percocet.  Nurse Mae giggles when she walks in on me doing my exercises and tells me that I am the only person who does them without a physical therapist standing by.  On a dark morning, Nurse Michelle shared her favorite nugget of wisdom with me: “It is my resistance to what is that causes my suffering.”  Nurse Jorge taught me how to take a shower without getting my foot wet.  Nurse Miriam called me from her home to give me the name of a web site that we had been talking about the night before.  Nurse Ingrid brought me a “magic eraser” from home so that I could clean my laptop.  Mind you—all of these things are happening while these nurses are just “doing" their jobs—taking vitals, administering medication, assessing changes, etc. 

Since being in the hospital, I had one day that I had a nurse who mixed “doing her job” with subtle put-downs, an attitude of annoyance when I asked questions, and an unwillingness to respond to my basic needs in a timely manner.  Although she technically performed the duties of her job, her attitude nearly crushed my spirit.

My realization for today is that people can have an amazing impact on the world by serving others with joy and love.  May we all be a blessing—even when we are just “doing our job.”