Archive for the ‘Nyel Stevens’ Category

The Long and The Short of It

Thursday, January 23rd, 2020

Actually, when it comes to our up-and-back trip to Seattle yesterday, there was no short of it.  Just long and longer.  Ten-plus hours driving I-5 in the rain.  Five hours up (including two pit stops and a ham sandwich lunch break); six hours back with one fast in-and-out pit stop — traffic never at a stand-still, but a three long slow-downs between Seattle and Olympia. Two hours at the UMC Bone and Joint Center.

We liked the doctor, a specialist in orthopedic oncology  Not that Nyel’s missing hip etc. had anything to do with cancer.  It’s more a matter of which orthopedic specialists have the most experience/knowledge in reconstructing complex bone situations.  After much searching and being sent from one specialist to another this last year, we think that Nyel has finally found the “right guy.”   He was young, thorough, to the point.  He will be consulting with his colleagues.  In the meantime, all options are still on the table (so to speak) and he suggested that Nyel also aggressively pursue non-surgical options.  As in physical therapy.  Since we’ve exhausted the local possibilities, we are reaching out, first across the river and then we’ll see.

As we were driving back to the beach we learned that there had been a shooting in Seattle, not very near where we had been, but…even so.  Fortunately, we were oblivious while we were in the city.  Not like the time in February 2016 when I-5 was completely closed down between Olympia and Tacoma because of a shooter  running amok on both sides of the freeway.  That was truly scary.  This time, not so much.  But a chilling reminder that “the emerald city” is no different these days from any other area infested with gun-toting multitudes.

It was great to get home.  We warmed up Nyel’s made-from-scratch mac’n’cheese, counted our blessings, and talked about how to proceed.  There’s no place like home!  Especially after a long, stress-filled day!

Check, Double-Check, And We’re Off!

Wednesday, January 22nd, 2020

5:00 A.M. Alarm — CHECK!

Up, bathed, coiffed — CHECK!

Aunt Rye with Banty Chicks c. 1940

Pills taken, breakfast eaten — CHECK!

Chickens fed and watered — CHECK!

Lunches made, thermos of decaf filled — CHECK!

Books for inevitable waits ready — CHECK!

Car packed  — CHECK!

7:00 a.m. off to Seattle — CHECK!

We hope and pray that this specialist has some

Oysterville Stagecoach c 1880

positive suggestions for Nyel’s “next steps.”  It sure will be worth this and every other up-and-back trip to Seattle no-matter-what-and-weather-be-damned!  Cross your fingers for us!

Travelin’ with Nyel

Friday, December 6th, 2019

Subaru Forester

Thursday, December 5, 2019

Up at the crack
Off in the dark
Seattle bound.

Another opinion
Perhaps a chance
For Nyel to walk again.

Cheese Platter

Pray for dry roads
And light traffic
And a good bedside manner.

A stop at Whole Foods
Or Trader Joe’s
For cheeses we don’t see here.

Party planning I’ve found
Is a fine distraction
From everyday hard stuff.

 

A Lot to Think About

Tuesday, November 12th, 2019

An Orthotics Option?

Today Nyel had an appointment with the Hanger Clinic in Astoria.  They deal with orthotics and prosthetics.  In case you are not clear, orthotics is that branch of medicine that deals with the provision and use of artificial devices such as braces.  Nyel already has a complicated knee brace that was helpful in stabilizing his leg after his quadriceps parted company with his knee for the third and final time.  Now that he no longer has a hip, he needs something more.  Perhaps something that goes from hip to ankle and involves cables attached to his good hip for extra stability.  Complicated and not altogether ideal.

However, the physical therapist at OBH strongly advised him to look into the possibility.  Nyel’s ultimate goal is to be able to walk again with a cane.  However, without the stability offered (hopefully) by a sophisticated custom-built orthotic, there really isn’t a path forward for him.

While we were at the Hanger Clinic, the word “amputation” came up for the first time.  In that case, a prosthesis  (artificial leg) would be the way to go.  There are many advantages, apparently.  And, even if he can get reconstructive surgery (which he is looking into), there are no guarantees that, down the line, amputation wouldn’t still be required.  So, part of the equation to consider must be whether or not to try “smaller” fixes first.

A Prosthetic Option

A crystal ball would be good.  In lieu of that, the Hanger clinician said that she would be glad to put Nyel in touch with patients who have had similar problems (though she admitted that she had only seen a few with Nyel’s complications).

There was lots to talk about on our way home.  Nyel, as always, is pragmatic — weighing pros and cons and making arrangements to talk to his various doctors and, if possible, to someone with a similar case history.  Bless him!

It was “Happy Birthday to Nyel!”

Monday, August 5th, 2019

Oysterville Regatta 2017 – Photo by Mark Petersen

One way or another, we salvaged most of Nyel’s birthday weekend.  We made it home from Portland in time for the second and third heats (races?) of the Regatta.  Afterwards, we got Nyel into his wheelchair and wheeled him down the middle of Territory Road with half of Oysterville and the Regatta Dinner guests walking along behind us.  “The only way to travel!” Nyel said.  In my mind  seventy six trombones led the big parade.  Only appropriate for his 76th birthday!

At Lena’s, we were greeted by Tucker and Carole’s son, Charlie, who managed to wheel Nyel over gravel and lawn and rough spots to seat him at the head of the nearest table.  Soon, the table filled with friends who filled us in on the first race and proceeded to treat us both like visiting royalty! People brought us food and beverages and there was even a surprise chocolate cake (a four-layer CostCo special, I think) and the whole crowd sang Happy Birthday to Nyel.

Regatta Pinata Grandkids 2018

A dinner highlight was Tucker singing three (count ’em! Three!) Regatta songs this year.  My favorite and the one I think should become THE official regatta song — was to the tune of “Where have all the flowers gone?”  Here is the truncated version which you can probably figure out:  Where have all the lasers gone… gone to summers every one; where summers… gone to memories;  where memories… gone to stories; where stories, gone to grandkids; where grandkids… gone to lasers every one.

On Sunday our long-time friend “Tricky” came down from Bainbridge and the three of us hooked up with Noel at the Bridgewater in Astoria for Nyel’s birthday dinner.  Lotsa sharing of “geriatric war stories” and even more reminiscing about the “olden days” of forty or fifty years ago.  It was lovely to catch up with one another  though we missed Noel’s wife, Patty, who was back east at a school reunion.

At home, there were presents — all food related, including a new slow cooker (his old one died) from son Charlie plus a hefty book called  Crock Pot – The Original Slow Cooker Recipe Collection.  Nyel’s comment:
“A great birthday and a real improvement over spending the day in the hospital.”  Amen to that!

 

Where’s my white hat?

Saturday, August 3rd, 2019

I arrived at St. Vincent’s last night to find that Nyel has been a) diagnosed with yet a new infection — chronic osteomyelitis — and that he does not “qualify” for hospitalization.  Everything that was done could have been accomplished as an outpatient says the hospital.  And, since that is so, he does not qualify for admission under Medicare Part A’s rules and we will be billed for the Part B deductible.

“So does he need to be here?” I asked.  There was quite a bit of arguing.  I don’t think Nyel and I “won” but we were told that “No, he doesn’t need to be here” and “No, they are not going to prescribe antibiotics as they are not indicated.”  Whatever that means.

“Then, get Nyel outta here!” said I.  Or something like that.

They are preparing his discharge papers as we speak.  There is far more to this story but… if we leave soon we might even catch the tail end of the Oysterville Regatta!  And, for sure, the Regatta Dinner!  The St. V saga can definitely wait.

Situation Normal AFU at St. V’s

Friday, August 2nd, 2019

I guess in some ways it’s reassuring that St. Vincent’s Hospital didn’t suddenly (since Nyel was last there for six weeks in April/May) get better.  When Nyel was admitted night before last, things looked hopeful.  But now… same old, same old.  At least we know we weren’t crazy the first time around.

The orthopedic surgeon who performed the original (failed) surgery and one of the two “clean-outs” seems to be in charge.  Maybe.  Or maybe not.  As of yesterday, he wants to open Nyel up and clean out the wound (again!) as it has become infected (again!)  The infectious disease doctors and the wound care doctors and the cardio doctors and perhaps even other ortho doctors wanted to do an MRI to try to get more information.   They were advising against surgery but as of yesterday a.m. — the MRI was off the table (so to speak.)  Surgery was on.

By evening, surgery was off the table and the MRI was done.  Apparently, the doctor-in-charge was overruled. As far as Nyel knows, no surgery is planned.  Oh — and let me add that though many doctors have seen and talked to Nyel up close and personal, he has not yet seen the orthopedic surgeon during this stay.  Not hide nor hair.

But it’s the back-story that makes it all the more interesting.  At noon on August 11th Nyel had a follow-up appointment with the ortho surgeon.  Nyel had been home for over a month and had been under the care of Harbor Home Health.  The head nurse was pleased that Nyel was going into Portland for the follow-up appointment.  She had some specific questions about the wound site and whether or not the wound-vac (the pump to which Nyel was attached) was still necessary.

I drove Nyel and his wound vac to Portland (actually to an office in Beaverton) for his appointment.  The doctor was pleasant and chatty but said he “wouldn’t bother” looking at the wound site.  “But… we drove three hours…”  When Nyel mentioned that his home care nurse had some questions about continuing the wound vac, the doctor said that she should be “perfectly capable” of making that decision.

That the home health nurse was frustrated by that news is totally understandable.  A few days later when she suspected the wound was infected, she contacted the doctor who then sent orders for a blood test.  “Yes” came the result.  “Infection.”  The doctor then asked for a culture from the “seepage.”  The nurse picked up the ordered testing materials from the hospital and did the culture.  At that point she also removed the wound vac and showed me how to apply wet/dry dressings — the protocol always used, she said, when there is infection in this sort of wound.

Yesterday, at the hospital, Nyel was asked who made the decision to remove the wound vac.  (He was also informed that he would probably continue to use it for up to a year or a year and a half. YIKES!) Furthermore, Nyel was informed that a culture should never have been taken from the surface seepage.  These criticisms/concerns were (again, “apparently”) coming from the ortho doctor but, as mentioned previously, he has not seen Nyel face-to-face.  And he was the one who ordered the culture.

As for the pain (which is why he went to the ER in the first place on Wenesday night)  — “they” say it is because his body is laying down calcium deposits trying to rebuild his femur.  That could continue for up to three years.  Of course, the femur cannot be “rebuilt.”  Calcium is not bone — no blood supply etc.  But the body doesn’t know that.  Or so the experts are telling Nyel.”  They have increased his pain medication.  Is that working?  “Except when I move,” Nyel says.  “Then, on a scale of one to ten… it’s about a seven.”

 

 

 

 

 

” An’ lea’e us nought but grief an’ pain…”

Thursday, August 1st, 2019

Dick Hawes

It promised to be the best weekend of many-a month!  Friday our long-time friend Dick Hawes was to come from Bainbridge Island in time for our Friday Night gathering.  He planned to stay through Monday for the first good visit we’ve had in almost two years.

Saturday is the Oysterville Regatta, followed by the Regatta Dinner — usually a festive gathering with upwards of 80 people!  Regatta Day is the highlight of Oysterville’s summer and Dick and I had worked out how we would get Nyel down to the end of the lane in his wheelchair to see the races.  Also, unbeknownst to Nyel, Carol and Tucker were planning to open the dinner festivities with a cake and have everyone sing “Happy Birthday to Nyel” as a special surprise for him.

Noel Thomas

Sunday, August 4th is his 76th birthday!  The plan was that Noel Thomas would join us and Dick at the Bridgewater Bistro for a quiet birthday dinner — probably one of those affairs that begin with the “organ recital” (as in which ailments each is dealing with and how) and morphing into exaggerations and lies about the good old days.  Except with that threesome, the truth is often stranger than the alternative.

But last night the gods did it to Nyel again!  Severe pain prompted a call to the EMTs and a trip to the ER at Ocean Beach Hospital.  As of one or two this morning, he was back at St. Vincent’s for evaluation and possibly a third “wound clean-out” surgery.  I will join him tomorrow afternoon when, the gods willing, George Hill will have my car repaired and road-ready.

Waiting for Nyel

The good news is — no sooner had Nyel arrived at St. V’s than he was notified that the wound-care team, the infectious disease team, and the cardio team will all be weighing in to the orthopedics surgeons on any decisions about next steps.  A few minutes ago he called to say that if surgery is indicated, it won’t happen until tomorrow (to give his blood thinners a chance to dissipate from his system). Also, the infectious disease people have him scheduled for an MRI (as we speak) to determine if he might have chronic osteomyelitis — a bone infection that will not require surgery but could keep him in the hospital for a while on IV antibiotics.

We think it’s the latter scenario we are hoping for (especially the non-surgery aspect) but we are trying not to anticipate anything at all.  And we have very little information as yet.  As Robert Burns so succinctly put it:

The best laid schemes o’ Mice an’ Men
          Gang aft agley,
An’ lea’e us nought but grief an’ pain,
          For promis’d joy

 

“Dr. Day” and “Dr. Night” (so to speak)…

Friday, July 12th, 2019

Drizzly Dawn on Willapa Bay

Two long days this week.  Tuesday we went up to Seattle to see Nyel’s cardiologist — his first face-to-face with him since before that horrible six-week hospital stay in April/May/June.  The first visit since he became a really-o, truly-o invalid (in body though not in mind or spirit.)  Thursday we went to Portland to see the orthopedic surgeon who (though not by intent) was responsible for Nyel’s current status.  The days and the doctor visits couldn’t have been more different.  Day and night you might say.

Tuesday we left home at seven, a drizzly dawn that didn’t get much better weather-wise all day.  Actually worse in places along the I-5.  To leave that early meant we had to get up at four.  One of the realities of the invalid life is the time it takes to do all the required medical “stuff” — requirements that we feel we do well to complete in two hours.  That gave us another hour for Nyel to eat breakfast and pack a lunch while I showered. dressed, and packed the car.  Wheelchair, check.  Nyel’s meds, check.  Urinals, check.  Etc. etc.

EKG – Heart (not Nyel’s) in Sinus Rhythm

We got to the UW Medical Center in time for Nyel to have labs done before his appointment.  And an EKG.  The doctor listened attentively to Nyel’s “story” though he was already well-acquainted with most of it through the magic of shared medical information on the internet.  He laughed in delight at the EKG results — “You’re in sinus rhythm!” he said.  He said it again and again, continuing to smile from ear to ear.  Not that Nyel has any control over that particular aspect of things… but we felt like he was getting full credit.  It’s a first in years… maybe getting rid of the pacemaker was a good thing?  Hard to tell.  An upbeat, forward-looking visit all the way around.  Home at 11 p.m.  Quick dinner.  Bed and the sleep of the righteous.

Yesterday we left at eight so were able to get up at our usual time and even did an errand on our way through Seaside.  (Dropped off Music in the Garden tickets to friends Paul and Lana Jane.)  Although it was drizzly to begin with, by the time we arrived in Portland it was sunny and hot.  Thank goodness for the car’s A/C.

Nyel’s Left “Hip”

This time, the offices to which we were directed were in Beaverton — very toney and upscale as opposed to the offices off Barnes Road where we went in June.  The Dr. was cordial, wanted to see what range of motion Nyel had been working on but he did not want to see the wound.  “Our nurse is eager for you to say whether or not I can get rid of the wound-vac,” Nyel said.  “Oh, if she is a wound care nurse she’ll know,” he said.

A discussion ensued.  It was obvious he wasn’t planning to examine Nyel but finally suggested that the nurse take a photo and email it to him.  (Like we drove into Portland for that bit of wisdom?)  He said there was no need of an X-ray this time either but Nyel insisted.  “I’ve never seen an X-ray of this hip,” Nyel said.  “I don’t know what’s there now that the ball and socket and four inches of femur are gone.”

After considerable thought the doctor said, “Gristle.  Just gristle.”

Great “bedside manner,” eh?  We were both totally bummed.  What a difference in doctors!  Day and night!

 

 

Ready! Set! Tuesday!

Sunday, June 16th, 2019

Beard Trimming 6/15/19

I was once told by a doctor that you know a hospitalized woman is ready to go home when she starts putting on makeup again. It’s not quite the same with guys — at least not with Nyel, but when he asked me to bring his beard trimming kit and a big mirror, I certainly knew that homecoming is on his mind.

Yesterday he got rid of six weeks’ worth of whisker-growth and looked oh so much better!  He also conceded to use one of those spiffy shampoo caps again.  It’s not the  first “shampoo” he’s had during his days of confinement — not by any means — but he isn’t crazy about the method or the result.

The Dreaded Shampoo Cap

“The doctor said ‘no showers til the wound vac gets removed’ and that’s likely to be a month or two more,” I pointed out helpfully.  (NOT!)  Nyel has been looking forward to a shower ever since he first heard the words “when you go home.”  Before that, he had other things to worry about.  However, yesterday he told me in no uncertain terms that he was planning to at least get his head under water.

“I can stand and lean against the kitchen sink,” he told me.  I bit my tongue just a little.  I do think he can safely do that with the wheelchair directly behind him and me (hovering) within reach.  I know it will be the first of many sentences beginning “I can …” !  What a guy!  I hope my hovering instinct quickly morphs into clapping and cheering!  So far… so good!