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EXTRA! EXTRA! READ ALL ABOUT IT! BOTH LEG CASTS REMOVED!

From Barbara:

This was a red-letter, high-fiving, fourth-of-July celebration day. The headline: The casts on BOTH of Bob’s legs came off!!

We arrived at the orthopedic surgeon’s office this morning, as planned, for a check-up of Bob’s legs. Dr. Jebraili had told Bob three weeks ago that if things looked good, he’d probably remove the cast on his left leg. But Bob had been terribly disappointed to learn, at the same time, that the right leg was still in such bad shape that there was no telling when it would be free of its cast. (It has an artificial bone, bolted in place in an extremely difficult surgical procedure, and an ankle that had been shattered in the accident.)

Then, this morning, after looking over the x-rays, the doctor thought a bit, and said to Bob, “Tell you what – I’m going to take off both casts.” He pointed to the pictures. “The left leg has healed nicely. Plus, the right leg is healing – and I think it will do better if you start using it.”

Both Bob and I began to cry with joy. We watched as the doctor opened the casts, removed cotton and bandages, and then – there were his legs – much thinner, the right one somewhat askew, pale but real. Bob gazed at them with amazement, as if he’d never expected to see them again.

He will get new casts that can be worn to give support as he starts to put weight on the legs, and removed when he’s resting. The doctor wrote out his prescription for rehab, shook Bob’s hand in congratulations, agreed that this was a terrific step forward, and told us to come back in six weeks. Wheeled back to the waiting room, Bob gave his news to the assembled patients, and got a cheer.

The news makes a tremendous difference, as you can imagine. Bob’s rehab had entered a kind of slow-down. Because he was unable to put weight on his legs, he was reaching the end of rehab eligibility (circumscribed by insurance regulations), yet was still in need of a program providing medical care, assistance, and enough exercise to keep him moving forward. He was in a holding period, waiting till he could really make progress. With the casts off, the windows of life are now open again.

Bob’s smiles were radiant as we waited for the Para-Med van to drive him back. As always, he tried to express his feelings in words. “All my hopes are validated.” You could see in his face that he was searching for a way to define the moment. “I can see the power of family and love. Now I’ll count my blessings and step up to the plate.”

We give thanks.
Click here to send Bob a note! (4)

"This is my new story."

Today started out not so well, with a prolonged coughing seige that was finally alleviated with a nebulizer treatment ("thank god for the nebulizer," Bob said). After that, things were pretty much on the upward curve.

When Susie arrived this afternoon with a bagfull of clean clothes, Bob donned a t-shirt and shorts immediately - as far as he could without assistance. While he & I chatted, waiting for the aide to arrive to help him dress the rest of the way and get into his wheelchair, I heard what sounded like a little rock concert down the hall. But by the time I got to the dining room to check it out, it was coming to a close. Phooey! How could they not include Bob? Oh well, they don't know how much music - this music - means to him. But what to do now? I asked the musician, a one-man-band playing golden oldies, if he'd mind staying a little longer to play one last song for Bob. It's his music, I told him, and music means the world to him. "Twist my arm," he said with a smile, as he handed me a playlist for Bob to choose from.

The dressing and transferring took awhile, followed by the taking of vital signs. I was afraid the musician would give up on us, but he was waiting when we arrived. "I'm Bob," Bob told him. "I'm Jeff," the musician said. It had only taken a second for Bob to select "Lean on Me," by Bill Withers, and he joined in singing with the opening words. Jeff said, "Yeah! Sing along with me!" So we both sang melody and harmony through the whole thing, Bob taking half of the call and response at the end of the song. An old lady in the room sang, too, and smiled encouragingly at Bob throughout. When the song was done, Bob said, "I flew through the air, and I survived! This is a great song for a survivor!" Many thanks all around, and "God bless you" from Bob to Jeff.

Outside on a second blue day in a row (unusual this rainy spring), Bob said, "I flew through the air, and I survived. This is my new story." And so it is.

Click here to send Bob a note! (3)

"I flew through the air!"

It's been an up and down week, a week of on-the-one-hands and on-the-other-hands. On the one hand, for instance, Bob passed his swallowing test Tuesday and can now eat regular food and drink clear, unthickened liquids. He reports a new-found love of apple juice, applesauce and 2% milk. Today he ate a few french fries.

But on the other hand, Bob's being bounced out of the rehab hospital he's been in for about a week - an intensive program which turns out to be inappropriate for him at this point. At our progress meeting with his rehab team on Thursday, his various therapists gently but frankly used phrases like "impulsive," "lack of safety awareness," and "poor planning skills." Not much progress, not making progress, no progress, one after the other reported. The fact that he can't put any weight on his legs yet makes everything too hard. They all agreed that a transfer for now from "acute rehab," which this is, to "sub-acute rehab," i.e. a nursing home (where he'd get less intense rehab and, we'd hope, more social and recreational opportunities) is called for. And equally significant, Blue Cross requires "measurable progress" in order to keep paying for his care. So it's goodbye for now to Shady Grove, at least till Bob's legs have healed enough to support him. His rehab social worker here is coordinating with two or three possible nursing homes, and we're hoping that one of them will be both good and willing to take him. We'll find out next week.
On the one hand, Bob is still extremely upset, feeling "like a caged animal" in his "boondoggle of a bed," enclosed as it is with a zippered tent to keep him from falling or climbing out and injuring those legs again.

But on the other hand, his helpers have made sure to keep his phone inside the tent, and he's called several times with greetings, weather bulletins and requests for clean clothes. On the one hand, Bob's been very angry and sad this week. He's cried during all our visits, an hour or more at a stretch, as we sit with him holding his hand, wracking our brains for an approach (empathic? philosophical? breezy? distracting? humorous? silent?) that'll help ease his mood or lift his spirits. Mostly to no avail. "I want to go home!" has been his refrain. Home not being just "home," of course, but "before." I want to go back to before this all happened. (And who wouldn't? How could he not feel that way?) And don't give me any of your happy talk.


But on the other hand, there was today. Bob called us this morning, and Susie and Melanie went over to see him this afternoon. Bob was watching TV when we got there, but he turned if off as soon as we walked in. He greeted us enthusiastically, and, we talked as we waited together for the aides to take him out of bed and put him into his wheelchair, asking about his accident. "You don't remember?" I asked. "No," he said. So I told him what he'd told me about it when he was still in the ICU. "You told me that all you could see was the gas station and the trees," I told him. "That sounds like you were flying through the air."

"I flew through the air," he said, with wonder and awe.

He thought quietly for a minute after that. "You know the song Both Sides Now?" he asked me. Sure. "Well," he said, "it's like I've looked at life from both sides now." He paused. "From win and lose to hit and run. It's life's illusions I recall. I really don't remember much at all." (Those of you who know the song with easily see where his words converged and diverged from the actual lyrics.)

At that point, the aides arrived to transfer him to his wheelchair. Melanie and I went into the hall to wait for him. "I flew through the air," we could hear him telling them over and over. We wheeled him out into the cloudless blue afternoon, taking him the full circuit around the hospital building, his first "walk" outside since April 15. As he rode, he reflected more about the morning of his accident. "It was dark and raining," he said. "Otherwise it would never have happened."

Afterwards, sitting outside the hospital entrance and chatting together, Bob got suddenly quiet. "I'm sorry," he said, "I just got sad. I was thinking about how I missed the Springsteen concert." And he started to cry. "I know, Bob," I said, "that's why David got in touch with Clarence Clemons." He kept crying. "This won't be our last chance," I said. "Let's think about next year." He kept crying. "Well, let's go upstairs and have a concert ourselves," I said, remembering the keyboard in the rec therapy room. "Okay," he said.

Up we went. Melanie and I found the keyboard and power cord, moved a table and pushed Bob in. He pressed the on button. "This is a song Michael McDonald did when he was with Joe Walsh and the Doobie Brothers," he announced, "Takin' it to the Streets." He segued from that to another Doobie hit, "Listen to the Music," and from there into "Levon," by Elton John and then to "You May Be Right I May Be Crazy," by Billy Joel, winding up with "New York State of Mind." We clapped and woo-wooed after each selection. "New York State of Mind - that's a great one," I said when he finished it. "No Billy Joel medley would be complete without it," he answered. And then he pressed the off button and looked down at the keys. "I'm tired now," he said.

It was supper time anyway. So we put back the board and the cord and the table and wheeled him into the dining room. "I think this is where you need to be now," I said. And while, on the one hand, it was time for us to leave, on the other hand, Bob said, "I think it is," and kissed us goodbye.

Click here to send Bob a note!
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