"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.
Cape Cod 40% Reduced Fat 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!

The Fōth (Fourth, 4th, ¼)



My maternal grandfather, William [Uncle Billy] Phillip Moore died in August, 1925 leaving a 70 acre farm behind with no house as the log cabin had recently burned down. His family consisted of his widow, Rosa Pearce Moore, and five children, aged 15 to 24, who lived with the nearby relatives, especially Uncle Charlie and Uncle Sam.
Uncle Billy and Rosa - my grandparents
(This portrait was photographed circa 1900 and was not discovered until the 1970s by my mother in a small closet under the stairs!  She surmised that the portrait was kept hidden, because it would have been considered much too ostentatious during the depression!)

To replace the log cabin, a four room house with attic and full front porch were built mainly with lumber sawn from the 70 acres.  The windows, doors, and hardware were purchased from Roxboro Lumber Company.  This is still stamped on some of the unpainted wood doors yet today.  Because of the fire, a separate kitchen building stood behind on the side south of the house.  Between the front two rooms was a hallway leading from the front door.   The northeast room was daughter Alma’s bedroom, and the northwest room was the parlor.  Behind these two rooms were two more rooms being my grandmother’s bedroom on the southeast corner, and the dining room on the southwest corner.  This dining room was the largest room in the house and because of its southwest exposure was the warmest and brightest room.  It alone had four windows, while all the other rooms had two windows each.  Not only was dining done in this room, but also it was large enough to be a sitting room as well, probably what today is referred to as a “great room.”  Sometime prior to 1940, Bill added two more rooms across the width of the south side.  Next to the big room was a new kitchen with a walk-in pantry.  Grandmama cooked on a wood stove with an oven and two overhead warming bins. Electricity arrived about 1948 making possible running water from a well, instead of hauling water from the spring.  Bill then built new cabinets with a built-in sink.  The other side of the south addition was a screened in porch.  Again in 1948, the porch was enclosed and a bathroom was added to the southeast corner of the porch.


Three members of the family were left to live on the farm as daughter Lula became a teacher, married and moved to Virginia; Jenny studied nursing, married and move to South Carolina, and Sara studied nursing at Watts Hospital in Durham and married there.  Alma became a teacher and continued to live at home and owned the first car in the family.  Bill spent his time farming the 70 acres.  Grandmama cooked, cleaned and did the household work.  She would spend many hours in the dining room, reading and doing handiwork.

Exactly how my grandfather’s estate was divided up among Grandmama, Alma, and Bill are unclear to me, as I have not found a will.  Both my grandmama and mother have explained the arrangement to me over the years.  Alma, the oldest and unmarried schoolteacher got the house and five acres surrounding it.  Bill, also never married, got the remaining acreage for his farm, where he built a two-story log cabin with large rooms on each level; later, he added two more rooms behind the log cabin.  All of this he built himself, and when he was not farming, he worked as a carpenter.  There were many other buildings on the farm including a two-story pack house with full basement, stables, chicken house, tobacco curing barns (two very old made with logs), and corn crib.
Pack House (left) and Bill's House (right)
So, what did Grandmama (the widow) get?  She got the Fōth and a lifetime right to live in the home!  What is a Fōth (pronounced with a long O sound)? Thus, she was to receive one-fourth of the farm’s income from growing tobacco.  After the sale at the warehouse, she was to be given a quarter of the proceeds.  It was sold in multiple bundles on the warehouse floor with lots of separate receipts.  Grandmama was not always sure that she was getting her rightful share, and demanded to see receipts.  Bill was known to spend a buck or two on whiskey and beer!

Why did Rosa even need any money – the Fōth?  Alma went to the A&P for grocery necessities spending her own salary. Despite all the biscuits and cornbread, Alma bought “loaf bread” especially to make tomato sandwiches.  Right there at hand were the dairy cow, and chickens, and a couple of hogs, not to mention the one acre garden in the summer.

Rosa Moore needed money for the following special items:
·       Snuff! 
Yes my grandmama had a nicotine habit and satisfied it with dipping snuff. Her brand of choice was Tube Rose.  She made her own dipping brush from a twig of the black gum tree.  She kept a pint or quart glass jar on the floor beside her chair to spit in.  Sometimes she used a metal tin can instead. Never make the mistake of accidentally kicking over that container!
·     
Saturday Evening Post which she read cover to cover every week when it arrived. The Post introduced me to the art of Norman Rockwell, who drew the most covers.
·       

Progressive Farmer magazine.
·       
Farmers Almanac in which the calendar must be followed! Know when the last frost will occur.  Forecast published in August, 2013, has been remarkably accurate for the 2013-2014 winter!
·   
Coats and Clark thread.  There was always sewing to be done, whether it was mending, crocheting, or a bobbin to be wound.  Four doors away on the corner of my block in Durham, NC was a neighborhood grocery store.  Right at the front next to the cash register was a glass display of threads.  I was usually sent with a color thread to match up.  The thread was wound on wooden spools, which never could be thrown away, because they would be repurposed as pot lid handles!  In the 1940s, feed sacks were indispensable for material for making some clothes, particularly pajamas.  Yes she made my pajamas.  Rosa had an authentic Singer foot paddled sewing machine, which she famously carried out of the burning log cabin home.  My mother had one also in our dining room next to two bright sunny windows.  Grandmama crocheted beautiful colorful edges onto pillow cases and towels for gifts.  She could also make lace – the doilies for the table tops.
·       
Gifts for her grandchildren on special occasions.  When I graduated from high school, she said that she wanted to give me a gift that I could use in college.  So, I chose Merrian-Webster’s Collegiate Edition Dictionary.
·       
Shoes which she bought at Roscoe Griffin in Durham.  She only had one style, which was black leather ankle high lace up.  She never ever wore anything else on her feet.


·       Certain undergarments, most notably a girdle.