Throwback Tuesday - Thanksgiving Edition

Just a Baby

High School

At UNC-CH Polysomnograph in the Sleep Disorders Lab, which I started.

Awaiting Renovations . . .

Hoping that my contractor will get to work on my major project soon.  The bed was taken down some time ago leaving some furniture along the sides of the room.  The job to be done is to rip up the old carpet and replace it with laminate flooring.  Then the carpet in the bedroom hallway will likewise get the new flooring.

The space in the hallway is just barely wide enough for my wheelchair.  The contractor will smooth surfaces and remove old door moldings that hit my knuckles some time.

My "Z gauge" model train collection along left side of hallway.

After all of that is done, we can move my hospital bed from the living room to my bedroom.  Try to regain some semblance of normalcy to the living room.

I have been successful at clearing bags full old papers that I had to review to see if any were all that important.  The most important ones were regarding the Stephen Moore Genealogy that I have been working on for years.  Magazines by the ton were thrown away, only keep my National Geographics!   Still needing to be thrown out are a lot of old books and binders that were work related.

Oh, did I mention that we have 30 ton dumpster parked in my driveway?

My son, Greg, has been a trooper in helping me with all these tasks.  Never knew that throwing away old stuff could feel this good!

Physical and occupational therapy have been occurring two to three times per week, and the therapists as well as myself are happy with the results, though I still get frustrated that I cannot do more -- especially standing and ambulating.  I still have to use a "slider board" to move from bed to and from my wheelchair and bedside commode.  By the end of the day I am really exhausted!

BEING HOME IS GRADUALLY GETTING BETTER.

I am gradually getting better, now having picked up the ability to move from bed to bedside commode to wheel chair using a slider board.

Since my bedroom is going to be remodeled with new flooring and new doorways, I am temporarily using a hospital bed in the living room.  The hospital bed is most uncomfortable, in which I get stuck and unable to move, especially my legs were are like a ton of weight!

The home health nurse is still dressing my left cellulitis leg every other day.  Physical therapists and occupational therapists are now coming out two to three times a week.

At least I can move around my house and get into the kitchen and computer study with my wheel chair.  There is still talk of of a powered wheelchair.

Biggest job at the moment is removing clutter, which has always been one of my handicaps, but now is a necessary challenge

HOME AGAIN ... . . but with mixed blessings

I came home from Silver Stream Rehab on Saturday, October 19, 2014.  At first, all seemed to go well.  Transferred into and out of the SUV with the wheelchair and used the wheelchair ramp for the first time.  Then on Sunday morning, I fell trying to make it to my wheelchair from my bed; had to call 911 for them to get me off the floor and into the wheelchair.

Since then, my leg muscles have gotten weaker and weaker, now to the point that any transfers are impossible.  As a result, all my time is spent bedridden.  The home health agency has completely dropped the ball providing me with NO physical and occupational therapy during the past two weeks.  Nurses have come out every other day to change my left leg cellulitis bandages.  The home health agency has decided to "drop" me because they feel that I am "unsafe" in my own home.  I am appealing that decision.

In the meantime, I am asking my primary care physician about sending me to Duke or Chapel Hill for  intensive muscular dystrophy clinic  intervention.

Each morning from 10 to 12 am, I have CNAs come to my house at my expense, to help with toiletry, bathing and dressing, as well as minor chores such as doing laundry.

I am stuck between the proverbial "rock and a hard place."  Suggestions, anyone???

"Baby Doc" Jean Claude Duvalier Dead At Age 63

"Baby Doc" Duvalier 

Jean Claude Duvalier was my patient.  I traveled to Haiti for the express purpose of performing an EMG and nerve conduction velocities on him in his countryside villa.  "Baby Doc" died on October 4, 2014 at the age of 63 of a heart attack. 

From an earlier post:

One of my more memorable experiences was with Dr. Zwibel, when again I had EMG machine, will travel. This time we went to Haiti to perform an EMG and NCVs on Jean Claude ("Baby Doc") Duvalier. From the airport we were transported to the home of the embassy official where we spent the night. The next day we were taken to a theater in Port-au-Prince where we transferred into three black Buicks (we weren't allowed to ride together) escorted by the Tonton Macoute on a high speed trip on narrow back country roads to the villa that Duvalier had some distance from the capital. We sped by the locals cooking their meals alongside the road, and I feared that the cars would hit some of them, but I was just as sure that if it happened, it would be a hit and run. Arriving at the villa, Baby Doc and his wife Michelle, were watching videos of which Baby Doc had a large collection. The doctors interviewed the patient who only spoke creole french, but Michelle interpreted with her fluent English. Her primary concern was that some medications that a local doctor had prescribed might cause impotence. His medical history revealed that after spraining an ankle, the local doctor had put a cast on it for months, and when the cast came off, he had severe weakness in the leg, which had prompted our visit from the states by the State Department. The testing proved that no great harm had been done, and that his weakness was just from long disuse atrophy resulting from the cast. To show his appreciation, Baby Doc gave each of us a collector's set of gold and silver coins that had been cast in his honor.

I Want To Go Home

The last time I was in my home was June 3!  That was the day I went to the Emergency Room due to a cellulitis infection, ended up in the Intensive Care Unit, very delirious and almost died. The month before I was in the hospital having a pacemaker/defibrillator implanted.  So, since June 3, I have been a patient at New Hanover Regional Medical Center and/or Silver Stream Rehabilitation.  Almost four months and I want to go home soon.

The good news is that the cellulitis ulcers and wounds are really beginning to heal nicely, but I still have  to have my left lower leg wrapped on Monday, Wednesday and Friday.

I am still very wheelchair dependent and can walk only short distances with my walker.  At least I can make transfers now  between bed, bedside commode, and wheelchair pretty independently.

Anticipating going home soon, I have had a 35 foot wheelchair ramp built that goes from my front porch down to the driveway which includes two 90 degree turns. After the treated wood has dried out, the ramp will be painted green to match the house trim.

No doubt I will also have to make some modifications inside the house as well, such as widening doorways.

PICC Line comes out today as last dose of IV antibiotics are given.

Selfie sitting in front of the mirror in gym.

It is 4:00  pm on this Friday afternoon.  The last IV antibiotic was administered

 and the PICC line pulled out just after that. 

Tomorrow I start taking the same antibiotic in pill form twice a day.  I am hoping to have more energy and feel better now that is over.

In the window are my orchid plants here at Silver Stream as I attempt to take care of them.

Silver Stream Stories

It seems that I had my own 9/11 disaster this week, which in retrospect would have been funny enough to win $50,000 on AFV if it had been video recorded! This past week physical therapy obtained an UpLift seat for me to use.

UpLift seat in a chair

 It gives me a boost to lift myself from a low chair to grab my walker and make a transfer and works great -- well a little to good in this case.  At 6:30 in the evening after dinner, I was straightening up my room.  Needed to add some distilled water from a gallon jug  on the floor to my CPAP reservoir.  Put the reservoir on my bed, and then rolled to the side in my wheelchair to grab the gallon water.  Remember that I am in my wheelchair on the UpLift seat and the wheels of the chair are not locked!   As I leaned down to pick up the water, my weight on the seat shifted enough for the lift mechanism to go into action.  It ejected me, the wheelchair moving backwards, and I landed sitting on the floor.  Thank goodness, other than a sore bottom, I was not hurt.  In reach was my nurse call bell, my room door was open and I yelled "help" and the nurses were quickly  in the room.  They got the Hoyer Lift to get me off the floor and into bed.

Hoyer Lift machine

The next morning, I had an appointment with my infectious diseases doctor, whose office is also located two blocks away on Silver Stream Lane.  The attendant arrived and tried putting me in my wheelchair in the back of the van that they have for transport.  BUT my wheelchair was an inch or two too  wide to fit on the lift mechanism.  So deciding that she needed the exercise to lose weight, Kim pushed me on foot to the doctor's office.  After the appointment was over, she hoofed it back to get me.  I got some sun and fresh air and Kim got some exercise!

Dr. Berthold was pleased with the progress of my healing leg cellulitis.  She said that the IV antibiotic

IV pump at work

would run for another week via the PICC line.  Then the PICC line

PICC line where it enters my right arm

would be removed and I will start the same antibiotic (Keflex) by mouth.

Left leg cellulites unwrapped on 9-12-2014 

A Bit of a Setback this week . . .

With a return of the infection, I have been back at NHRMC for a week now.  Today, they inserted a PICC line for the continuing IV antibiotics.  So I should be returning to Silver Stream Rehab tomorrow.

On Robin Williams:

Blogger David Jeffreys said...

How can such a talent so great be taken away by a depression so deep, when those around him lost vigilance ???

I am saddened that because he held all our hands, we were not holding his.

and NO, NO, NO, . . . Robin Williams is NOT in a better place.

_______________________________

Robin Williams dead; family, friends and fans are 'totally devastated'

By Alan Duke, CNN

updated 10:19 PM EDT, Tue August 12, 2014

Williams was pronounced dead at 12:02 p.m., it said.

Williams was last seen alive at his home, where he lives with his wife, at about 10 p.m. Sunday, the sheriff's statement said.

"An investigation into the cause, manner and circumstances of the death is currently underway by the Investigations and Coroner Divisions of the Sheriff's Office," the sheriff's statement said.  "Coroner Division suspects the death to be a suicide due to asphyxia, but a comprehensive investigation must be completed before a final determination is made."

An autopsy is scheduled for Tuesday, the sheriff said.

Williams made at least two trips to rehab for drug treatment, including a visit this summer, and he underwent heart surgery in 2009.

Williams, born in Chicago on July 21, 1951, studied theater at Juilliard School before taking his stand up act to nightclubs. 

He proved his dramatic acting skills in "Good Will Hunting," a 1997 film that earned him a best supporting actor Oscar.

His memorable movies over the past three decades includes "Good Morning, Vietnam," "Dead Poets Society," "Mrs. Doubtfire" and "The Birdcage."

A bad day is all about perspective - - -

copyright Hallmark Shoebox

A Health Update For My Friends

It feels so good when my blogger friends reach out to find out how I am doing, as the cajun just did!

_____________________________________

the cajun said...

Hi David, with no other way to reach you, I wanted to reach out agin. Please continue to post updates when you can. We're all anxious to hear your news.
We're all going through something and it's always good to let it out and share your feelings with others. That would be US!
Take care, my friend. and do write when you can. Think of it as therapy. I do and it works. I get feedback from folks like you who know what I am talking/writing about.

Cheers.
Here's to Silver Queen!

___________________________________________________

(PS: my email is david at ladyslippercove dot com. You know how to change it to the correct format.)

Silver Stream Entrance Sign

Well this is day 39 in Silver Stream Rehab. and I am still not ready to go home, although I want to so bad!  Progress on the walking with a walker front: today I walked 180 feet with a therapist  holding on to me and a wheelchair following closely if I suddenly need to sit down.  I am doing leg exercises with weights on my ankles, plus a lot of arm exercises.

Front side of Silver Stream Rehab

Two major concerns continue:  The ulcers (lymphedema/cellulitis) on my left leg are just not healing.  My  doctor just came in and said they are trying to get me to a lymphedema specialist on the outside to treat and dress the wounds daily.  The other big concern is standing up from anything lower than bar stool height.  To that end, we have begun investigating a power wheelchair that has the the capability of raising the seat height as much as 12 inches, which will make transfers easier.  As a result, I am also investigating having a wheelchair ramp built onto  my front porch and raising the porch floor level to be even with the interior floor level.  Again, the power wheelchair seems like a favorable idea from my doctor's point of view, especially since the LGMD will only progress over time and my muscles will get weaker.

Existing front porch and steps

Thanks to all of you for the many cards and well wishes.  My spirit gets a boost with each one!

Rehabilitation

Silver Stream Rehabilitation

Two and a half weeks after being transferred from the hospital to Silver Stream Rehabilitation, I had my first planning conference yesterday.  I have been approved for three more weeks of rehab, with the probability of getting a wheelchair.

The major objective is to get me back on my feet and independent.  Before hospitalization, I was able to ambulate around my home with a walker.  Now I need help to stand up and then to remain standing for a short period. Using one side of the parallel bars, with help, I pull myself to a standing position from the wheelchair.  Today, for the first time I walked the length of the parallel bars between them, three times.  Progress!

Also I have leg exercises consisting of sitting and doing marches, kicks, swings, and ankle extensions. These are repeated in the afternoons with a different therapist, plus I do them on my own often. Occupational therapists work on my arms to strengthen them as well.  These involve lifting weights, bars, and a 20 minute without break constant bicycling action with my arms.  Today, I went 5.4 kilometers -- a new record for me.

The facility has 110 beds and is quite large with very long halls.  My room is about as far away as one can get from the front entrance, gyms, and dining room.  I try to wheel myself to the front, but my wheelchair does not roll easily, so this becomes very difficult. (See last paragraph about a new wheelchair.)  This place should be renamed "The Chandeliers" because there are chandeliers everywhere including right outside my room.  The chandeliers  all burn incandescent bulbs, so the carbon footprint is huge.

I have a large private room which is very nice.  The bed a not very comfortable with a mattress that is too thin for my  big body.  Originally the length was 75 inches which is exactly my height, but they found a ten inch longer mattress for me. 

The administration, nurses, and CNAs are good and attentive with a few minor exceptions. 

The room has the usual amenities including TV, private bathroom, with walk-in shower.  So far, I have not been able to use the bathroom due to my lack of strength and have had to settle for sponge baths in the bed.

Being diabetic, I have been very disappointed in the menu items, which are carbohydrate intensive.  I just discussed my dietary preferences asking them to remove all bread, waffles, pancakes, french toast, and biscuits from my trays.  After all I do need to lose a lot a weight so that my weak muscles will not have so much to deal with.  I asked for more vegetables and fruit.

Eggs, grits, and a sausage gravy covered biscuit

Then I had a discussion about my meal preferences, and for lunch, I received a tossed salad with chicken strips, yogurt, and melon.

Wound care of the left leg cellulitis ulcers has been continuing with daily dressing changes.

Since I arrived, I was assigned a wheelchair that just would not roll or be pushed easily.  Today, they assigned me a new wheelchair that rolls easily, so now I can move myself easily all over the facility. Big improvement.  Because the wheelchairs are too low for me to stand up from, every evening they have to use a Hoyer lift to move me from the wheelchair to the bed.  In the mornings however, I can transfer myself from my bed which I have lifted into a very high position to the wheelchair using my walker to stabilize me during the transfer.

Progress!!!  Goals seem more attainable!

Where I have been . . . .

in a word -- the hospital.  New Hanover Regional Medical Center [NHRMC].

21 March: to the ER for the cellulitis in my left leg, but was not admitted.

25 March -> 2 April: Cellulitis.  Irregular ventricular heart rhythm noted. 8 days.

14 May -> 30 May: Admitted with a heart rate of 171 bpm and had to be shocked [cardiac conversion].  Then had pacemaker/defibrillator implanted in my left chest wall.  16 days.

3 June -> 20 June: Severe infection in left leg with sepsis - staph. Admitted to CCU.  Became delirious for several days.  First PICC line had to be pulled due to blood stream infection.  IV antibiotics given via second PICC line for 14 days.  17 days.

Total NHRMC days so far this year = 41 days.

20 June -> present:  Silver Stream Rehab

When I was admitted to the hospital on June 3, I was ambulatory with my walker and able to get around inside my house using my chairs which are elevated.  Now with the help of two therapists, I can stand from my bed when it is elevated to a very high position.  Still cannot take any steps.  Very discouraged! Lost a lot of strength while in the hospital and my limb girdle muscular dystrophy seems to be taking over.

TMI QUESTIONS: WHAT'S IN A NAME?

1. Do you have a favorite flower?  Several and the rose is among the top of the list!  I also like daffodils,

 azaleas, magnolia and bougainvillea a lot!  I just bought a beautiful purple bougainvillea hanging basket for my deck,

Bougainvillea

 along with a red knockout rose, and a red geranium.

Geranium and knock-out rose

2. Do you like your name (first)?  My first name is David, which I do like very much.  I am a "junior" named after my father, so I also have his middle name of  Elmo, which I hate.  My mother was upset that I did not name my first born son, the "III."  No way was I giving him the name Elmo.

Elmo

3. Does your name have a meaning?  Beloved.

4. Do you have nickname?  No, and I dislike being called Dave.  David in Hawaiian is "Kamika."

5. Would you ever consider changing your name?  No.  I like my last name "Jeffreys," but I would prefer it to be "Moore" which is my mother's maiden name, because my Moore ancestry is so illustrious.

6. What name have you heard that you hate?  I don't care for those African-American names that sound made up!

7. What name have you heard that you love?  My preference is toward English, Irish, and Scottish names.  My sons are named Brian and Gregory, and my grandson is named Ian.

8. How did you pick the name of your pet?  Had a hard time finding a new name for my Pembroke Welsh Corgi and "MoJo" seemed to come out of nowhere!  Turns out it has been the perfect name.

MoJo, just a puppy on his way to his new home!

9. Do you name inanimate objects? Name some of them.  No.  However, some of my friends have always named their vehicles, but then they are not inanimate, are they?

Limb Girdle Muscular Dystrophy

For the past 15 years or so, I have been suffering with limb girdle muscular dystrophy (LGMD) which has slowing become worse.  It is a genetic disease that runs in my Moore family tree primarily involving those muscles at the junction of my limbs and trunk, such as my low back muscles, hips, upper legs, and shoulders.

Fortunately, it did not start until after age 50 and has been slowly progressive.  Ambulation is now becoming more of a problem, and I have begun relying on a walker for balance and using my arm strength.  My walking distance is also limited by my shortness of breath, a holdover from my pulmonary emboli.

Driving is still possible however, because my lower legs and arms are still strong, so I can steer, accelerate, and brake without difficulty.  My Mitsubishi Endeavor SUV is a big help because it has a high center of gravity, and the seats are at the perfect level that are even with my backside for sitting down and getting out of the vehicle.

The longest ongoing problem has been arising from chairs and sofas, which are usually too low for my weak muscles.  Fortunately my bed happens to be very high above the floor, so it is not a challenge.  My favorite leather arm chair in the living room is a Bob Timberlake "Gentleman's Chair" which I have elevated on four inch blocks (bed risers/lifters).  For cooking, I have an armless drafting chair in the kitchen which is on casters, so that I can scoot around from the refrigerator to the counters and stove easily.  It has a hydrolic lift post that elevates it nicely.

For the past 10 years, I have been using an "Old Dollar" leather office chair in my small office at the back of my house.  It is so old that the hydrolic post would not go high enough and I kept adding cushions to the seat for height.  Though, it has been so comfortable and still looks good, it just had to be replaced with a new office chair that is more practical.

I have been shopping at Big & Tall Clothing stores for years, so imagine my surprise when Office Depot advertised a "Big and Tall" leather office chair.  I went into the store for a test drive, and discovered its hydrolic post rises to a very good height, and the seat is wider and deeper than most other office chairs.  It is even rated for 500 pounds!  It was on sale for $150 off the list price at $250, plus I could spend an extra $8 dollars to have them assemble it.  I hate assembling anything, and the reviews said it took two people and was very difficult to assemble because the pieces were so heavy.  So now, I am comfortable at my computers again.

Big & Tall Office Chair!
(Carpet is beige -- don't know where the green came from.)

For more information on LGMD, click on this link:
http://mda.org/disease/limb-girdle-muscular-dystrophy

TMI QUESTIONS: SNACK TIME

SNACK TIME

1. Do you prefer salty or sweet?Actually, I have cravings for both.  Love salted peanuts and dark chocolate.  But I need to stay away from both because the salt leads to edema in my legs, and sweet is a no-no for my diabetes.

2. What was your favorite snack as a kid?

 Sour pickles.  I love sour pickles, which goes back to my paper route days as a teenager. There was a hot dog stand located where I picked up my papers every afternoon. They sold these giant sour pickles out of a jar for 15 cents. Every day I bought one and slowly sucked on it and ate it as I delivered my papers.

3. What is your favorite snack now?Sour pickles. At my local Harris-Teeter, they sell large whole Boar's Head sour pickles out of a jar in the deli section for 99 cents each. I usually buy 6 each week, and enjoy one in the evening before bed time. A couple years ago they sold Dietz and Watson large sour pickles out of a "barrel" which I preferred over the Boar's Head.

Cheese, especially Jarlsberg.

4. Healthy snacks are....?

Still not healthy, but healthier are 40% reduced fat Cape Cod Potato chips and Seneca apple and sweet potato chips.

   

5. Milk and what kind of cookies? Do you dunk?

I don’t eat cookies and drink milk.  The only thing I’ve ever dunked is a donut in coffee.

   

Krispy Kreme only, never  Dunkin' Donuts!

6. How do you eat Oreos?

Absolutely HATE Oreos!

7. What is your favorite movie snack?

Popcorn, especially Cape Cod Sea Salt popcorn.

8. Cake or pie?

Lemon chess and pecan pies are my favorite.  Also like coconut cake.

9. Ready Whip or Cool Whip?

Neither.  For those calories, it must be real whipped cream.

10. Potato Chips or Pretzels or Cheetos?

See #4.

Cape Cod 40% reduced fat potato chips.

Seneca Apple and Sweet Potato Chips.

11. Favorite kind of ice-cream - flavor and brand?

Harris-Teeter Premium Summer Peach.  Real chunks of peaches and none of those strange additives like guar gum!

12. Most unusual food you eat as a snack?

Sunflower kernels!