A few weeks ago, during my seemingly annual crisis of confidence, I deactivated Facebook & Instagram. I also changed my Twitter avatar to the wound vacuum that sat at the end of my Dad’s hospital bed back in May.
I’m including it here for folks to ogle:
The eagle-eyed among you should be able to clearly read the word “stump” written in Sharpie on the device. It’s written there because a) my dad had two wound vacs, and b) this was the one for the stump of his right leg, the result of a below-knee amputation.
A few points of order before I get into the nitty gritty (and hopefully non-grisly) details:
- My dad was never a smoker
- My dad doesn’t have diabetes
- Somehow my dad has vascular disease
1 & 2 make 3 a head-scratcher but we’ve been building towards this nightmare scenario for a few years.
If you haven’t read the harrowing story about the aneurysm & heart attack my dad had back in 2013, you should do that now.
If you have read my account of that experience you should know that my dad has had several fem-pop procedures in the intervening years to guard against another aneurysm and keep blood flowing to his legs. Spoiler alert: one of them didn’t work.
Without going into too much detail my folks moved to Florida a few years back, rehabbed a house on the “Forgotten Coast” which then got totally demolished in last year’s hurricane and, in between, my dad had a graft put in behind his right knee so a “pseudo-aneurysm” didn’t graduate to full aneurysm status.
Make sense?
So after the hurricane left my folks functionally homeless they bounced around to the homes of friends, relatives, and children until they took a trip to Indian Wells for this year’s tennis tournament. My dad has terrible pain & discomfort in his leg so they had to cut their trip short to stay with us and be examined.
Here’s where shit gets weird and worse.
Dad has surgery to replace the bypass behind his right knee. All seems well. Mom comes home to sleep in our guest bedroom instead of the hospital.
A little after 10pm she’s in the living room, visibly shaking, asking for someone on the other end of her phone to repeat the news they’ve shared and which she’s having a hard time processing. I take the phone and listen in.
Dad is back in surgery. He crashed while seemingly OK in the ICU recovery bed. Bleeding from his hip (surgery site), seemingly losing blood and bottoming out of his BP. No one knows why but they’re trying to find the cause.
Mom & I head to Atlanta Medical Center in their truck – I drive – and spend hours in the ICU waiting room. Sometime past midnight a surgeon gives us a 20-minute talk that’s the equivalent of the shrug emoji.
We go home exhausted but happy that he’s still alive and wait to see him the next day.
Dad, chipper as ever, recounts his side of the ordeal the next day. Remembers feeling woozy and losing consciousness but no worse for the wear. They release him a few days later and he spends a couple of weeks at the house convalescing.
Dad seems mostly fine but is very run down. He sleeps a lot be we mostly chalk that up to recovering from surgery. It’s a big damn deal to have a cadaver vein put inside of you. The scar alone, two ruler-length ribbons – one above the knee, one below – are enough to make me need a nap.
No one is too concerned, except my Mom who wants him to move around a bit more to aid in healing.
Turns out she was right to be concerned.
One afternoon after Mom had picked up our girls from elementary school Dad was in such discomfort & pain, she had an ambulance come & get him. I met her at Atlanta Medical again and Dad ended up spending the night in the hospital. The ER visit was like a throwback to his initial aneurysm from 2013, but he seemed generally OK.
Maybe it was just the flu? or so the thinking went.
It was not.
10 days later he’s in awful pain and back in the hospital. They’re having to take out the vein because it’s gotten occluded somehow. Maybe it’s an infection or maybe it’s just a failure. Doctors aren’t 100% sure, they just know his blood flow is terrible.
The fix is that they’re going to put a plastic vein in his body since the wait for another cadaver vein of the proper length is too long.
I don’t remember my brother coming to stay with us, but I know he was there in the ICU when they brought Dad back from surgery. Dad’s intubated and still asleep and now has a single scar running from his inseam all the way down to his ankle.
His foot is purple. The sharpie-written note on the whiteboard reads “No pulse LRE”.
No pulse lower right extremity.
I share a glance with my brother and we walk Mom into the hall. None of this is good.
At this point I think we meet with 3 of the 4 surgeons from the vascular practice who’ve been helping Dad. Their respective attitudes range from determined to dour, but they all say we have about a day or so of waiting to see what happens.
None of them bring up amputation, but we do. It’s always an option but they want to wait and see.
When Dad wakes up they can’t remove the tube right away. Having to deal with a parent as they grapple with their own muteness and the gravity of the failed and (now) failing bypasses was heartbreaking. He was already ashen but the prospect of more surgery, the simple fact that he’d lost 24 hours he couldn’t remember, and our inability to discern his thoughts (especially my Mom) really frustrated Dad.
This all happened on a Monday or Tuesday and by Thursday morning it was clear that his leg was in dire shape. For reasons related to how many good veins were left and how multiple bypasses on the same system tend to get less effective as surgeries progress, he had a choice: take a less than 10% chance on another surgery or proactively have a below the knee amputation.
As fate would have it, he made his choice and was booked for surgery within the hour and was under the knife only 90 minutes after choosing.
If you’ve read this far, it might surprise you (or not) to learn that even after all of this drama, Dad actually had another post-operative setback. He had a skin graft to close his amputation wound a few weeks after surgery and, unfortunately, an infection was trapped in there so he had to have another surgery – two in fact – to remove the infected tissue and then heal slowly. Much more slowly.
It’s now been just over 6 months since the amputation and this coming Friday he’s hoping to get molded for a prosthesis. Maybe by Thanksgiving he’ll have the first iteration of his eventual new leg.
I know I’ve waited too long to get all of this written out because my brain is missing some key dates and other details could stretch for paragraphs or blog posts all on their own. I’m trying to be a little more kind to myself and realize that I needed time to process all of these events before I could commit them to the blog.
Hell, they didn’t even happen directly to me, but to say his struggle hasn’t affected me wouldn’t be true either.
Maybe now is the perfect time to be sharing this story. It’s a reminder that none of us is promised tomorrow (or even today, really) and that we should be thankful all of the time and hug our loved ones while we have the chance.
I know I’m going to be extra happy for the holidays this year.
Be safe out there.