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Thursday, July 18, 2013

Foot Surgery -- Again?

On Tuesday, we went back to the foot surgeon to have Bob's foot unwrapped and stitches removed.  The whole day started off on the wrong foot, no pun intended.

First, Bob woke me up early as he was terribly constipated. He's had more and more of this problem lately, and has really been off his regular BM schedule. Previously, I just charted his bowel movements on the calendar and when I saw that it was "time again" I would administer a laxative in the evening and, like clockwork, he would come through before the next morning. This used to work pretty slick, but is not working so slick anymore. And though I've adjusted the schedule, he is still catching me by surprise.

Anyway, so I gave him a suppository which works quicker than a laxative and figured he'd evacuate within a couple of hours. But no such luck. Three hours later, he is still complaining. Four hours later, still nothing. Finally, I had to, um, "investigate" and found he had a pretty good wad of stool impacted there. Which means get out the baby oil and the latex gloves and, well, I'll leave the gory details to your imagination.

This whole process put us greatly behind schedule. And even after I had him, I thought, cleared out, he still insisted he "had to go". So, I had to dress him while he sat on the bedpan. No easy feat. Then he insisted there was more "stuck" and I had to get out the gloves and the oil and repeat the above described process, not once but twice. By then, the clock is ticking and I am getting quite frantic as we are way behind schedule. Finally, I got him shaved, still sitting on the bedpan. It wasn't until the wheelchair transport arrived that he agreed to finish dressing and get into the wheelchair. Of course, we were dashing for the door. Because the transport van will leave if you are not outside within five minutes. That's the rule.

Once in the van, I sit down, attach my seatbelt and sniff, sniff... oh crap! and I mean this quite literally because I get a whiff of something distinctly unpleasant and it's coming from me. Call it my new perfume: "Eau de Poop". But I check my hands, my arms, and can't find the culprit ... once we arrive, I dash into the restroom, thoroughly wash up, but still there is a lingering smell... and I do hope it's just my imagination.

So we got to the doctor's office early and again the doctor is running late. The first person to come into the room was the nurse. She took off Bob's boot and the wrapping and then took off the electrodes and finally the gauze dressings. That's when I realized something was terribly wrong. Three of Bob's toes were indeed straight, but the last two toes, the smallest ones, are still contracted and curled up.

All week Bob has been complaining about his foot being "f--ed up" but I had figured it just hurt from the surgery and told him that, in so many words. Now, Bob is glaring at me, saying "See? See? SEE?" The nurse tells us that someone will be "in shortly" to take Bob to have his foot x-rayed. "Shortly" turned into 45 minutes. I have to call the transport and be put on "stand by", which means it will take forever to get home.  Finally, the x-ray tech arrives and wheels Bob away. When he brings Bob back, I can tell something is wrong by the look on Bob's face. I say, "What's wrong?" and the tech nonchalantly tells me that Bob "wet himself".

And sure enough. The condom catheter has once again had a "blow out" and poor Bob's shorts are drenched. I rummage through Bob's wheelchair pack and find a towel and try to dry him off. At that point, I am afraid to change his clothes because we are still in the doctor's office and I can just imagine the doc coming in at the exact moment when I have Bob's pants off. So I mop him up as best I can and drape a towel over his lap.

And there we sit. For yet another 45 minutes. Bob drenched in urine and me smelling of Eau de Poop. I tell you, we make a great couple!

Finally, finally, finally the doctor arrives. He is pleased with the first three toes. He says that he is surprised that the two smallest toes didn't straighten out. He had thought just cutting the tendon would relax them. He wondered, out loud, if he didn't make a deep enough cut. Then he says, "well, we can go in there and remove those knuckles too". Though first, we would have to wait for the big toes to heal and have those pins pulled out...

And I am thinking, no please, not another surgery. Because that means another $250 up front---and I already maxed out the credit card with this one, and I don't know how I'm gonna come up with another $250 up front--- not to mention taking him off the warfarin and the screwing around with the lovenox (more on that later) and the running around for pre-op testing etc. etc. and then, poor Bob having to go through this all over again....

But Bob is still complaining that those little toes hurt, so we'll see how it goes and do what we have to do...

Jeepers. What next?


Anonymous said...

So sorry to hear Bob may need additional surgery on his foot. Such a hassle to deal with in so many ways.

My wife was always fighting constipation problems and we finally found the solution to that problem that got her "regular", though induced. She was on three stool softener caps three times a day, plus three fiber caps per day, and finally, at bedtime, she took a dose of Meralax. She had a BM most days about two hours after waking in the morning, though constipation was still an issue occasionally. Being bedridden, inactive, and most meds saying constipation could be a side effect, it was a constant fight. If all else failed, a large glass of prune juice was the fall back.

Hugs and prayers, Dan

Susan said...

Diane, I really don't know HOW you do it all. I applaude your fierce spirit! You deserve a purple heart medal.
Dahn and I send our love,


Joyce said...

You mean his feeding tube did not pop open! Just when you think it can't get any worse-----it does. You do a great job of dealing with the stress. I know it is just one darn thing after another.
My spouse also deals with the constipation. I still have not come up with a good bowel regime for him, and I have tried several.
Hang in there Diane and keep that sense of humor. I think it is what helps us keep our sanity.
Joyce --from the blue house on the hill.

J.L. Murphey said...

Oh boy, such a bother. We run into this problem very often. We do daily Metamucil and stool softeners, if that doesn't work Miralax. I also give him Probiotics and a naturopaththic solution called "Calm." 1-2 days with no movement.

If that doesn't work, suppositories and possible search and destroy method you talked about. Day 4

Then if all else fails, Citrus of Magnesium. If that doesn't work it's a trip to the doctor. Day 5-6

So far, he's never made it as far as the doctor yet.

Rebecca Dutton said...

I had no idea severe constipation could be so physically unpleasant and emotionally disruptive until I had a stroke. I take two teaspoons of Miralax with EVERY meal. Many meds cause constipation so impactions may decrease after Bob if off all the drugs the doctor put him on after surgery. I certainly hope so for both Bob's and your sake.

Theresa Loder said...

Hi Diane
Oh my are some kind of Angel...
Rick also was constipated like that ...they sent him home from seven days in the hospital with no BM...he was also on extra Lasix to remove 40 lbs of fluid for CHF...
It was awful...I used the same procedure..
Poor Bob...having to go through another surgery...but if his toes are still painful, what can you do...
I am still researching ways to get you some help...with respite, transportation etc...I am not one to give up....I will message you if I find something...
Love, prayers and hugs

Theresa and Rick