Dark Days in the GPNW

We woke up to yellow/grey skies and ash covering the pickup and the RV. The winds changed, blowing smoke out of eastern Washington to here.  The arrival of the smoke and ash happened last night, at the moment the winds are dead flat calm, so this atmosphere will be with us for awhile.
This is a terrible picture taken with my cell phone this morning at about 8:15.  It gives the general idea of the color of the sun and sky.



I scraped this from a facebook post put up by Friends of the Columbia Gorge.  The camera is currently positioned facing the Cascade Locks to give a live view of the Eagle Creek fire.  This is not the only fire burning in eastern Washington.



It does seem like the entire world is on fire, under water or under siege.
 
In Myanmar, 125,000 Rohingya refugees are walking barefoot through sucking mud to get to Bangladesh.  Daw Aung San Suu Kyi seemingly has not lifted a finger to prevent the military from destroying their villages and murdering the people.  The military says it’s retaliation for resistance by the Arakan Rohingya Salvation Army.  This is ethnic cleansing.

Here, in the US, we have our president vowing to deport all the Dreamers who came here as children despite the fact that it will cost our GDP somewhere around $105 billion dollars over five years.  Enlightened self interest would suggest that we not do this evil thing.  He’s also threatening to cease trade with countries that trade with North Korea.  That would be China and Saudi Arabia to name two.  Where does he think steel comes from these days?  China.  He wants a trade war on top of everything else.  And let us not forget the cost to clean up Houston and after this weekend Florida with Hurricane Irma on the way.  Despite these looming expenditures, he wants to give the rich a tax break.  I don’t think good things are ahead for this country.  It’s a good time to be old.

On the not dark side, Jim is doing better.  Drug consumption is down and walking distances are up.

Things Are Not as Bad as They Were for Jim

Wednesday and Thursday were just horrible.  At one point I was seriously considering taking Jim to the ER at Valley and getting him readmitted to the spine floor.  His back muscles had started spasming and it was really painful.  Friday was better.  We managed a trip to Costco and a big grocery shopping at Safeway.  That included some walking since we park at the far end of the parking lots to avoid door dings from other cars.  Today’s pain levels are better than yesterday.  Jim is now down to oxy every 6 hours instead of every 4.  We’re not sure how to continue the taper.  Longer time intervals or fewer drugs?  It’s a difficult choice because if it was wrong, pain ensues.

The allergic dermatitis is not as itchy and it’s not as red as it was.

So, we’re pretty happy things are better.



It’s hot again.  The high today is supposed to be 90.  90! In Seattle.  I guess the old, cold and wet summers are a thing of the past.

Jim Continues on the Path

Oy, it’s been a few days.  I have to tell you, this surgery is not for the faint of heart, it hurts.  Our first phone call to the surgeon’s medical assistant for more oxycodone was not encouraging.  So, we cut back on dosages to make the supply we had last a little longer.  That was not a good outcome.  Jim has been suffering like an animal for a couple of days.

Then the contact allergic dermatitis at the surgical site kept getting worse. When he came home, there were some lines of agitated skin from the bandages they used.  We quit using them, but the dermatitis kept getting worse.  This morning we went in to see the surgeon.  I was watching his face when Jim pulled up his shirt.  He was somewhat shocked.  They put vancomycin in the incision to prevent infections.  It could be a response to that, it could be from one of the many things they put on his skin to kill any bacteria.  The mystery is why does it continue to get worse now that he’s home.

That’s the incision, which is healing nicely, and that’s the allergic response in red.  It’s a terrible burning itch and it’s swollen.  It’s a three inch incision.



It’s good we went.  They’ve put him on a low dose of Prednisone for seven days.  We also got more narcotics which I am very happy about, as well as cortisone cream to smear on the dermatitis.

Jim’s been on narcotics every four hours, tylenol every 6 hours and a muscle relaxant every 8 hours.  I have spent a lot of time counting on my fingers to figure out which pills are due when.  If you find yourself in this position, may I recommend the humble white board as an organizational tool?



In other news, we have these tidbits from the internet.  This is a water spout photographed somewhere in Texas, courtesy of Hurricane Harvey.



This is from Twitter.  I can’t remember the rider’s name. Does it not appear to you that he is about to hit the deck?  It was during one of the stages of the Vuelta a Espana.



So that’s what’s happening here. 

Jim Leaves the Bus

Last night and today have been difficult.  When we left the hospital, they wanted Jim to take the drugs every four hours, instead of every three as he had been doing.  So, we did that last night.  Today we are back on every three hours.  Last night was not good.  We also failed on getting drugs to him in the middle of the night.  We will not make that mistake again.  Seven hours was way too long of a gap.

Today has been painful.  We’re wondering if it’s made worse by the fact that he quit taking Prednisone Tuesday, and its anti-inflammatory properties are wearing off.  When a person has spinal fusion, non-steroidal anti-inflammatories are also forbidden for three months.  NSAIDS interfere with bone production. 

Despite the discomfort, there have been two walks circling the RV park.  The good thing is that the walker is staying in the bus.



I promise that soon I will blog about something other than Jim and his back.  Our Fearless Leader has been providing so much material, but I know you’re all sick of it.

Jim Returns to the Bus

We were able to depart the hospital about 11:00 this morning.  Getting in the pickup was not as difficult as I had feared it would be.  I have to use the running boards, but Jim is tall enough that he can get his butt up on the seat and then pull his legs in.



This is where much of life will occur for the next few weeks.  This procedure is major surgery. Muscles and nerves are moved during the procedure, and they don’t like it.  They told us before the surgery that there would be six weeks of no bend, lift or twist.  They did not mention that to do so would cause severe pain.  Getting on and off furniture, the bed and the toilet are the major sources of pain.  When you lift your body up, you use those muscles in the back.  Since they’re currently angry, they get revenge.

We did end up renting a walker for a month.  It was an excellent choice.  He doesn’t actually need it for walking, but he does need it for sitting down and getting up.

So – now he rests, gets some sleep (which he was not getting in the hospital), and we wait for bone growth to occur.

The Day After Jim’s Surgery

Jim had a good day today.  The third day, tomorrow, is frequently a bad day.  Something about rates of inflammation, blah de blah de blah.  The surgeon gave us an acronym for it, which of course I can not remember, nor the explanation of why that is.  The older I get, the less recall I have.

Here is Jim walking out the door with his Physical Therapist.  She told us that 75% of people having this surgery go home with a walker.  The walker helps with balance and unloads the surgical site just a little.  At this point we don’t know if we’ll be buying one or not, but she indicated that Jim is a good candidate for not needing it.  Jim also walked up and down the four step stairs they have in the occupational therapy room.  That orange band is a strap that they grab if the patient starts heading for the deck.



This is Jim’s new hardware.  See the screws in his vertebrae? The screws hold the vertebrae in place with proper spacing.  There is cadaver bone acting as a spacer.



One of the things we’ve learned is that the spinous process is removed during the surgery.  They take the bone and grind it up.  It’s put back in to the space freed up by the removal of the disc.  The presence of the bone dust tricks the body into thinking there is a broken bone.  That results in the production of new bone cells in the area.  After about a year, the space between the vertebrae is full of new bone.  The screws become unnecessary, but they are never removed.  They’re buried in bone. Click on the screen scrape for more clarity.



The other thing you can see in this x-ray is the fix to Jim’s pelvis from 2006.  He has 17 screws from the surgery that rebuilt his pelvis after the crash.  At this point, he’ll probably never be able to pass through an airport scanner!



The PT and Occupational Therapist have been amusing to me.  They keep asking us if we have grab bars in the shower or shower chairs.  When we say no, we get a response (like a bug look) that wonders why we don’t have these things.  We’re in an RV!  There are no grab bars, a shower chair will not fit!  What do you want from us?  It’s fun to watch, I think they don’t get too many full timers.

Today’s key learning is this.  If you have compression of the spinal nerves with the concomitant pain, DO NOT SIT DOWN.  Jim is doing well because we kept riding.  After he couldn’t walk any distance, we kept riding.  I think we were still doing 70-80 miles a week after things went to hell.  The stronger you are before surgery, the better you will be after it.  If you can’t ride, swim.  If you can’t swim, then dog paddle or tread water.