Recovery Milestones

As Promised

Per my last recovery update, I will try to make future posts 💻 shorter and to the point, and focus on a few topics only.

As I’ve passed a few important recovery milestones this week, and am confident that I can start to see the light at the end of this tunnel created by trauma, I thought I’d share them with you.

Visit to Orthopedia (WBAT!)

Since I passed the waiting mark of 12 weeks from surgery on Tuesday, (which also happened to be my 54th birthday 🎉 , making me 53 years old – do the math) I had a follow-up appointment with the surgeon who repaired my ankle.

He poked at it a bit, and said it looked good, asked me if it was painful and gave me a written order to “Weight Bear As Tolerated” (WBAT) which is a green light to “therapy the hell out of it” as much as I can stand. (Pun unintended). 👣

To get to the appointment in Olympia, I had my first encounter with Paratransit ♿️ services. A bus showed up at the appointed time, and wheeled me into the back in my wheelchair, and securely strapped me in with ratchet straps attached to the wheelchair and seat-belts on me. me and my appointment minder Pharrel were off and running and made it early to Olympia for my appointment.

Paratransit Selfie – in Wheelchair

The ride was not terribly comfortable, being so high up I was pitched back and forth a bit with the sway of the road. On the return however, a small Dodge mini-van pulled up (20 minutes late) and I was wheeled in a specially constructed trough through the back hatch. The smaller, more intimate conditions of the mini-van was well received. There was even a seperate environmental control for the rider. 👍🏻

It seem to me that it might be a lucrative business to be in, as America’s population is only getting older (and less healthy) and it would be easy to get dispatched business from the regional ParaTransit services.

Paratransit bus interior

Since I have received permission to stand on my leg, and to start walking (shuffling, shambling, ambling?) I walked for the first time in three months. It was a glorious affair, as can be deduced from the smile on my face in the picture below.

Soon I’ll be walking out that door. <click for video>

I really didn’t have to put much weight on the walker, which was mainly for standing leverage and balance, as I am not being assisted in standing or walking. 🚶🏿

I ended up doing a few small circles inside the therapy gym, about 10 meters max. I will be walking as long as I can stand it today during my scheduled ⏱ therapy session. (post-therapy edit: I did 102.2 meters of walking today)

Weight Lost

My second big milestone this week, was my weekly weigh-in. ⚖️ I had been overdue for a weigh-in due to general busyness around here, and because I can stand, I don’t need to be hoisted up via hoyer. I can just stand up on the scale, and have my wheelchair backed out of the way.

Official weight as of February 14 is 334.6 pounds, which means I have lost 85+ pounds since I injured my ankle in late November. Whoo Hoo! 🎉

Weight Loss Progress Graph – 3 Months

I attribute the weight loss to simple mathematics. Diligently counting every calorie, no matter how seemingly innocuous has made it possible to know when the portions are big enough, and not to continue eating “just because.”

I highly recommend taking advantage of the health features of your smartphone, smart watch with connected apps to track calories and activity.

Another Move?

I said I’d try to make this update more brief, and I hope I’ve succeeded in that regard. I’ll keep posting updates. I’ll leave a slight teaser for my next post, and say that a third recovery milestone is on the horizon. As I had previously checked into the possibility of being admitted to CHI Franciscan Rehab Hospital, on the old site of the former Afifi Shrine Temple in Tacoma. Now that I have weight bearing status, I have started the ball rolling to get moved up there, where I will get additional therapy, with a specifically tailored regimen based on my needs, with the goal of getting me home after a two-week stay. Please wish me good fortune. 🔮

Gratitude

Thanks to all those who have sent gifts 🎁 , cards, snacks, etc. based on my plea for stuff and things. All of your support is valuably appreciated. Special shout out to Dwight, Jim, Rich, Chris, DaveO (UW), Adam, Scott, and the Pizza Hut driver who delivered a pizza 🍕 on my birthday since I was stuck here, and too much snow on the ground for visitors.

*See last post for contact, mailing info, and updated Amazon Wish List requests.

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New Digs in Xmas Tree Town USA 🇺🇸

New Temporary Home

As I stated in my last recovery update, I have been moved to a “Skilled Nursing Facility” in Shelton, WA, about 20 miles outside of Olympia, in the next county. I’m now at Fir Lane Health & Rehabilitation, with contact information and mailing address 📬 listed below.

As I stated in the last update, this place has the vibe of a somewhat rundown motel, off the beaten path, with limited amenities. There is an extra special decorative wallpaper along the crown of the walls in my room that is a constant reminder of the neglect toward interior design and the esthetic character of the facility.

With a new facility, comes a new routine. Whereas St. Peter’s allowed a bit of flexibility, and would accommodate the patient with respect to timing of meals, etc., I can expect no such treatment in current environs given my experience during the first few days of my stay.

First breakfast at Fir Lane

The above picture is of the breakfast I was served the first morning following my arrival. Sadly, it was one of the better ones I have received. Usual morning fare (example picture below) is two fried eggs 🍳 (my choice rather than standard scrambled), and one piece of toast with margarine. I have the option of dry cereal, oatmeal, or cream of wheat, 🍵 but they are carbohydrate heavy and aside from an occasional bowl of oatmeal with sugar free maple flavored syrup, I avoid them.

Not surprisingly, being served a single strip of bacon (average of less than twice a week) is a big adjustment over being able to order bacon 🥓 with every meal. The adjustment has been difficult, but I realize this is not a high priority issue, in a world with bigger problems and I will survive even with an externally imposed bacon scarcity. First world problem; ’nuff said.

Daily breakfast with bacon

For the first week, it was very hard to understand the system, as I had not been briefed on the protocol, schedules, or availability of food at mealtime, and otherwise. The whole process and procedures around getting fed here are needlessly complicated, and wholly inefficient, causing poor service, including slow meal delivery, mistakes, not to mention the largely unappetizing meals they put together for the residents. Aside from that, learning about the rigid schedule was difficult.

Breakfast is served starting at 7:45am in the main dining room for most residents. Any meal in the dining room usually takes 30 minutes for them to get to serving the plate of food, and sometimes a long wait just for coffee, ☕️ milk, or other beverage. However, if you arrive too late, (say at 8:35, as I did I one day) they might refuse to serve, and tell you to go to your room and wait for them to deliver your breakfast on a tray. Eating in the room is not a bad option, but the food comes later, and there is little recourse if they have served the wrong meal, or made some other mistake when serving.

Choosing daily lunch and dinner, which are served at 11:45 and 5:15 respectively, from the options available each day is required, and a small ordering slip is provided with your breakfast. An example of a daily meal menu is below. There is no significant choice for breakfast, as the same things are served everyday with only small changes, and no choice. Plus the few-but-far-between appearances of bacon or other adequate breakfast protein on the plate.

Fir Lane resident menu for the day

On the day listed above, I had a hard time choosing between the “Beef Pasta Casserloe” and “Chottage Cheese & Fruit Plate” (sic) for dinner so I punted for one of the very few alternative options, the so-called “chef’s salad.” Last week I ordered some avocado oil based sesame ginger vinaigrette from Amazon in order to avoid the higher fat and calorie dressing options (Thousand Island / Ranch / Blue Cheese / Italian) available here.

There appears to be very little consideration given to diabetic-friendly food options, even though a significant percentage of residents are diabetic. Keeping carbohydrates below my target of ~100/grams per day has been impossible due to the fact that meal choice is severely limited, and excluding all carbohydrate laden foods would likely mean a calorie deficit leading to daily nutritional intake being too low for my diet target.

Other Adjustments

The differences in food and nutritional resources available and the meal schedule are not the only adjustments I’ve had to make since I’ve been here. In the TMI department, (the whole personal hygiene arena,) things are a little less, shall we say, desirable? The night I was admitted after being transferred from St. Peter’s we discussed the issue of bodily functions. Since I can’t yet stand under my own power I need to use a commode chair, so they brought this monstrosity (below) and put it in my room next to the bed. The entire first night, this hideously designed, “monster-truck” of a commode stared at me in the shadowy darkness every time I woke up, looking like a skulking golem 👹 gloating in the fact that it was going to devour my very soul ☠️ upon the morrow. Very unsettling that.

Dramatics aside, I believe deep in my being that this abomination needs destroyed. Looking like it was designed by a wannabe Thomas Edison in a garage from parts purchased in the hardware department of Wal-Mart, it has six caster-style wheels, two or three of which are hopelessly sticky, making it impossible to push in the direction you actually want it to go, and offering resistance so that moving it with a person in place is akin to a line-backer exercise of pushing a blocking sled down a football 🏈 field.

Scary Looking Commode Chair

This is the chair I have been using to shower 🚿 in, with the entire and wholly undignified process consisting of the following:

• Get lifted into the air via Hoyer lift
• Lowered onto commode
• Get naked (usually done after defecation)
• Cover self with sheet
• Get pushed down hallway like blocking sled
• Enter “shower room”
• Shower (assisted by nurse’s assitant)
• Towel Dry
• Cover self with sheet
• Get pushed back to room
• Dress while sitting on chair
• Get lifted into the air via Hoyer lift
• Lowered into wheelchair or bed

As an example of of how my standards have “re-aligned” a bit, with my current situation, one of my most successful days here so far has to be the day I got the new commode, with drop arm(s). This much more ergonomic well -esigned commode chair 🚽 is a joy to use, in comparison.

More comfortable, user friendlier commode.

The therapist team helped acquire it from the maintenance department after a two day delay involving miscommunication, misplacing the chair and overall confuddlement on the part of staff. After it was found and retrieved from whatever black hole it dropped into for 48 hours, a hearty discussion ensued between the maintenance staff, the therapists and myself into whether it would be safe. After some stern insistence on my part, and a demonstration of me getting on/off the commode and with the ability to take off and put back on, my own pants 👖 it was decided I was “cleared” to use the commode without assistance. 🙄

Put One Foot in Front of the Other

The therapy I’ve been getting here is the best part (the only good part) of my being here. I’m clearly gaining strength and stamina in my left leg, and am able to use it to walk, stand, scoot around on knee scooter, etc. without too much pain, and my daily weight -lifting regimen 💪🏻 is giving me additional upper body strength.

View of the Fir Lane Therapy Gym

Me, looking a bit over-enthusiastic during therapy.

I’ve got an appointment with my orthopedic surgeon for Wednesday, February 13, 🗓 to ostensibly give me the official “okey-dokey” to start using the injured ankle and leg again to recover and ultimately to help me self-ambulate like before the injury. Given the snowpocalypse we’re currently experiencing, it’s likely that milestone will be delayed for at least a week. Le sigh. 😧

Snowy Entrance and Parking Lot

I seem to have let these recovery updates become increasingly unwieldy, a trait which I’ll endeavor to eschew when sending future dispatches by being more succinct, and sticking to a topic or two rather than giving fewer large “omnibus” updates.

As always, there is contact information below, along with a not-so-subtle plea for gifts and supplies. But hey, why not give me a jingle if nothing else? I’ll try to answer if I’m not busy with therapy or meal-time.

I’ll leave everyone with an amusing video of a song that has become my theme for the time being.

Contact Me!

📮📧🖥📲🖊

As always, contact me via FaceTime™, iMessage™, Google DUO™, or e-mail at jacob@stewarts.us. Also available on Skype™ (theunabonger), FaceBook™ for the purposes of criticism, praise, niggling, joshing, joking, venting, (but not proselytizing!), more serious responses, please click on the comment bubble and speak your mind to your heart’s ❤️ content.

Feeling generous? 💰 💵 send me tribute 👑 and gifts 🎁 via PayPal™, Google Pay™, ApplePay, Zelle, Square, or buy me something practical or fun from my *Amazon Wish List*.

Jacob Stewart
1430 Evergreen Park LN SW
Olympia, WA 98502-5901

^^ Address to ship supplies/gifts ^^

(Deprecated)
2430 N 13th St, Room 128
Shelton, WA 98584.
^^– Address Deprecated due to pending move. Send to above.

🎁 Links for Gifts to Send (including yourself!) 🎁

Help, I’ve Fallen and I Can’t Get Up – Week 10 Update

This blog entry title (Help, I’ve Fallen and I Can’t Get Up), will likely become the title of this whole series of posts regarding my injury, recovery, and pathway to health. By the time I finish them 🖋 I will be presumedly up, walking,🚶🏻 independent, and 100 pounds ⚖️ lighter. Maybe when I’m finished, they’ll be enough for a small 📖 book; but for now on to the overdue 🕟 update:

Additional Progress at St. Peter’s

Slowly but surely, while sticking to a strict diet 🥗 currently averaging ~1550 calories/day, and *trying* to limit carbohydrate intake to <100 grams/day, I’m gaining energy, still losing weight and feeling a little stronger 💪🏻 every day on the whole.

During weeks 8 & 9 of my convalescence 🗓 a larger emphasis was put on physical therapy. This mostly consisted of outfitting me into what can accurately be described as an oversized padded sumo diaper with parachute straps which attach it to a ceiling mounted lift/hoist. Kind of like a johnny jumper for adults, with a weight limit exceeding 500 pounds. The therapy consisted of hoisting me slowly on the edge of the bed while raising it, so that I could attempt to use my own power to get, and stay into a standing position. After I’m up, the hoist support is backed off, leaving me supporting my entire weight on my uninjured leg, and arms. At this point, mobility (with a walker) and strengthening exercises are performed for as long as my constitution and stamina will allow.

After a few more-than-expectedly painful sessions, a knee scooter 🛴 was introduced to allow me to take some pressure off of my weak and sore left hip, and to balance my weight on both legs, without putting any weight on the injured ankle.

Although this was extremely painful at first, it was necessary as a first step to getting my muscles used to standing/walking and build up those areas where atrophy had set in.

Along with this supervised thrice weekly workout, I continued with daily upper body exercises with weights, (7lb) and the TheraBand™ doing bicep curls, triceps extension, bi-lateral scaption, and lateral raises. 🏋 I ordered a 10 & 12 pound set to work with after I am moved to a skilled nursing facility.

Getting Physical Therapy by Aid of the Sumo Diaper Hoist

Progress on Weight Loss

In the (less than sixty) days I’ve been in the hospital, I’ve just recently crossed the 70 pounds weight loss milestone 💎 that marks 33% of my total goal. To do the math, that will eventually reduce me to 1/2 of my highest weight of 420 pounds, which I was on the day of my admission to the hospital. I’m currently (as of January 23, 2019) at 348 pounds, and I don’t intend to squander *any* the progress I’ve made when I’m back home.

Since I can’t rely on the detailed nutritional information Providence St. Peter’s was providing me, I downloaded, an am evaluating, a few fitness and nutrition apps 📱 that track calories, and nutrition info, as well as weight loss progress, exercise, and provide good diet tips and recipes.

Daily Caloric Intake Graph from Nutrition Spreadsheet

Hospital Red Tape/Bureaucracy/FUBAR

Symptomatic of the much grander dysfunction plaguing our national health care system, I ran in to some difficulties that had to be dealt with with a combination of support, guile, determination and self-advocacy.

Since being admitted to Providence St. Peter’s 🏥 hospital in mid November, they had been telling me that they would soon ship me off to a skilled nursing facility, to wait out my surgeon’s prohibition on using the ankle for anything for a full 12 weeks following the surgery.

Each time we spoke to by the hospital case-worker about post-hospitalization placement options, we were assured we’d get a chance to check any facility out, to make sure it met my needs without being a risk for re-injury that would create a possibly tragic setback in my recovery. We waited for them to provide us with a list of places, to no avail, as there was no place in the area that could accommodate me, and well, that suited me just fine, as I was getting good care where I was. If I had to wait it out, then St. Peter’s was the best possible place to be.

Apparently, talk of being informed, and getting a chance to preview possible facilities was all lip service, because when the first skilled nursing facility in the area (in the next county over, about 25 miles one-way) agreed to admit me, the case-worker went into overdrive to get me transferred, at one point even producing a threatening form letter stating that if I did not move into the facility as she was suggesting (insisting) I would be financially responsible for the hospital bills. The form serves no useful purpose other than one of intimidation to get the patient to accept whatever scenario is being pushed on them. This was done 15 minutes after Brielle had left the hospital after talking to the case-worker, and informed her she was going to go check it out that afternoon. After this hostile act, I told her I wanted the ability to speak to my insurance case-worker, an additional rehab facility that had come by the room to interview me for possible placement, and my physical therapy team, *BEFORE* I would agree to be moved.

To finish up without belaboring the issue, we had to get the hospital administration involved, and our case switched to a different case-worker, as I had previously been in conflict with the original over their accusation that I was not working hard to recover, and the false statement that I had refused physical therapy; an accusation for which the case-worker had to apologize to me when I raised a ruckus about the abusive behavior. 😡

Moving on Down

In the end, after consultation with the insurance company, and both the in-patient rehab center, and the skilled nursing facility, it was decided that I would move to the skilled nursing facility in Shelton, a quaint logging/lumber mill town once known locally as Xmas tree 🌲 capital of the USA.

Being loaded into the ambulance at St. Peter’s

Obligatory Ambulance Selfie

The ambulance ride from Olympia to Shelton was utter torture. Placed on a medical transport device designed by Torquemada himself, consisting of 3 millimeters of padding, and no lumber support on a metal table. I had to balance on my left side to keep the pain in my tortured coccyx from causing me to pass out. Them EMT assigned to transport me 🚑 stated that although it’s not at all comfortable, it’s required by protocol.

Brielle, insisting on making sure that they transported me safely, followed in her Subaru (Olygirl) chase car, snapping this picture during a traffic stoppage near the Washington State Capitol interchange during rush out at 5:30 pm.

The View From the Chase Car

Fir Lane Health and Rehabilitation Center

After being dropped off at the new Skilled Nursing Facility, and shown to my room, my mind immediately pictured a cheap motel, located in Ukiah California in the mid to late 80’s. It’s got that vibe, for sure.

Cliffhanger

I had originally outlined more topics for this update, but decided that it stretched on too long, and felt that it was best to break it up into two separate posts. I should have part II ready in a few days or so; please check back soon for details about my new routine, my impressions of the facility and the care I’m getting, and perhaps a few philosophical musings about life, the universe and everything. 👽✨💫🌒

Until that time, I’ll leave you with a picture of a spooky apparition, the so called “shower chair/commode” which was placed next to my bed the first night at the new facility. Although some design work clearly went into this contraption, it can’t help but to look as though somebody is assembling them in their garage with PVC tubing they purchased at the Fred Meyer hardware department. 👹

Scary Looking Commode Chair

Closing, thanks, ObContactData

As always, thanks go to Brielle, 💐 for many things including remembering to bring me a shoe, socks, etc., kicking bureaucratic ass, caring for the minions, and for support. Also, the million and one nurses and aides who have been taking care of me. The therapists, the guy who adjusted my wheelchair, (you get the picture.)

Contact Me!

📮📧🖥📲🖊

As always, contact me via FaceTime™, iMessage™, Google DUO™, or e-mail at jacob@stewarts.us. Also available on Skype™ (theunabonger), FaceBook™ for the purposes of criticism, praise, niggling, joshing, joking, venting, (but not proselytizing!), more serious responses, please click on the comment bubble and speak your mind to your heart’s ❤️ content.

Feeling generous? 💰 💵 send me tribute 👑 and gifts 🎁 via PayPal™, Google Pay™, ApplePay, Zelle, Square, or buy me something practical or fun from my *Amazon Wish List*.

Pax Vobiscum

Parking lot Wabi Sabi. #shelton #moss

View on Instagram http://bit.ly/2MANRQb

My new workout equipment. #pumpingiron #pumpyouup #barbells #hospitallife

View on Instagram http://bit.ly/2Rzjmiq

Nice refreshing scent. #olywa #hospitallife #aquavelva #aquavelvaman

View on Instagram http://bit.ly/2CR7cJv

Holidays in the Hospital – Week 6

Room Switch and Progress

Last Friday December 21, 2018, (the Winter ❄️ solstice ☀️ ) my nurse’s aid came in and asked if I heard they were going to move me to another room. As I was slightly dozing 😴 in the recliner chair I spend the majority of my time elevating my injured ankle, I answered groggily; “No, I hadn’t heard anything about that.” She proceeded to inform me that a room with a friendlier bathroom/shower layout was coming open, and she had arranged for me to move to this room. Within ten minutes, everything in the room was packed, and placed on my hospital bed, which was wheeled into the new room along with the heavy-duty commode 🚽 chair and recliner. They put me in the wheelchair and told me to take a lap around the floor while they set things up.

Shot of New Room – Chair in Corner

Shot of TV and Hospital Terminal

Shot of room entrance, commode, and bathroom/shower.

I was happy at the prospect of taking a real hot-water shower, as I hadn’t been able to in over a month since I’ve been there. Apart from the difficulty moving from the wheelchair, to the commode chair, which had been moved in and placed under the shower, it was as satisfying as I had hoped. After feeling refreshed and reinvigorated, I got back in the reclining chair, and proceeded to doze 😴 off, waking around 4:00 AM and proceeding to go back to sleep.

Holidays and Festivus

The lovely Brielle came to visit on Christmas, and shared a small holiday feast consisting of half a Starbucks Holiday Panini (Turkey/Gravy/Cranberry Herb 🌿 Stuffing) on a panini roll, as well as some potatoes 🥔 au-gratin and apple 🍎 cobbler. She also left mini stroopwafels 🍪, which are decadent and evil, as they caused me to break my daily carbohydrate limit by a grip. She also made an unannounced visit on Boxing Day, which was nice. This whole episode has been hard on her, as she’s had to deal with the furry minions by herself, without any help. All are either sick, just got fixed, an had recent tricky surgeries. The dogs and two young kitties have all been wearing Elizabethan collars to keep them from chewing on their surgery scars. At least one of the kitties has been a bad kitty, being a pill and raising a ruckus on a regular basis. 😈😼

Small Disgruntlements

Neighbors

Since I was moved to the 7th floor, I’ve always had a neighbor or two that are constantly disrupting the peace and harmony of my environment. When I first got moved up, I was near the nurse’s 👨‍⚕️ station, and my next door neighbor, and elderly man, had an alarm 🚨 set on his bed, that started a siren and proceeded to blurt “Do Not Get Up!” repeatedly over a loudspeaker. 📢 A contingent of two or three nurses and aids, would march into the room, and proceed to tell the occupant not to move, just hold on until they could help him. It was a constant struggle to sleep with the alarm going off several times overnight, as well as during the day.

Currently, after first being moved to a room with southern exposure (a good view of the helipad, but too much direct sun ☀️ coming in the window, causing heating and cooling difficulties) and then being moved into a room on the east side of the building, I’ve got a neighbor, I’m dubbing “The Groaner” who is constantly wailing like a pirate biting down into a tough piece of shark 🦈 gristle. AarrRRRrrr! RRrraawwWWW! It has been going on for days, and is quite a distraction. 😖

Food Service Woes

Breakfast tray, with Honey Dijon salad dressing instead of Dijon mustard.

My other current peeve is the food service. While they give you a great variety of healthy foods, (even on the carbohydrate restricted diet) they have a system that is problematic, and doesn’t recover well from small errors.

Today, I ordered a breakfast (pictured above) of salmon, 🐟 bacon 🥓, sausages, and scrambled eggs 🍳. They delivered a packet of honey 🍯 mustard salad 🥗 dressing, instead of the Dijon mustard I had ordered. 😠This is the second time they have done this in the last few weeks, probably due to a computer 💻 UI shortcoming, as the ordering process is complex for both the orderer, and the order taker.

Everything on the menu is “ala carte” which means you have to account for and order each item, including salt, pepper, mustard or tobasco and specify how many packets.

If they forget to bring something, even though it was on the ticket, you have to call back down and re-order it and wait another thirty to forty-five minutes for them to bring the item. It would also show up twice on your daily nutritional report, misstating that you had eaten two of them, instead of one. 😡

All in all, however, I am happy with the service they are providing, because it could be much much worse. 🤢

Carolers

On Christmas Eve 🎄 🎁 , there was a group of carolers 🎤 🎶 roaming the hallway. They walked on by without opening the curtain or stopping at the room entrances. I didn’t get any footage of the carolers, but I did get a video where you can hear them sing as they stroll by the room entrance.

Closing Notes 📝

As of this upcoming Monday, December 31st, 2018. I’ll have been in the Hospital for 6 weeks now. This extended length of my stay is entirely due to the fact that my obesity precludes independent ambulation. I am not allowed to use my right leg/foot for anything, most especially for supporting my weight, or standing up for several more weeks. My left leg has always been weak, with some hip pain when strained, and is consequently unable to lift me to a standing position on it’s own. I really am kicking myself for allowing my weight to get this bad, but as previously stated, I’m committed to permanent change for the better, in order to live and be healthy going forward. I’m sticking to my strict diet, working with the physical therapist, and greatly looking forward 🤞🏻 to the day when I have enough independence to leave the hospital. Peace ✌🏻 Love ❤️ to all; more updates upcoming!