Toenails, for most people, are simply trim and forget things. For diabetic old men they become thick, hard as rocks and damn near impossible to cut. And that fact did me in. For old men - especilly diabetic old men - well, I promise to post no pictures but here's Junior Welles with some music that hits the nail on the head.
Have you ever seen some of us old guys wearing beige-colored support hose? They help and I wear wore them all of the time. Those hose cost around $60 - but the shipping is free. Mine come from the VA. The problem is that, unless your toenails are smoothly trimmed, they will get caught in the socks. When they do, it's painful and the socks shred. Long story short - my big toe nail caught in the stretch hose. I had to cut myself loose.
Toenail clippers aren't meant for those of us with really thick toenails. That's all I had to work with. So, I tried. The clipper slipped and I cut my big toe. Some bleeding was stopped with a bandaid. No biggie . . . I thought. Frikken toe nail clipper.
Two days later my leg hurt like hell, my calf was swollen, and I considered going to the emergency room. It was Sunday and about 7PM. The dogs needed to be taken care of. I decided to wait 'til morning. Suddenly, the pain took off and I called 911. They transported me to Portland VA. As I was being loaded into the emergency vehicle, neighbors gathered. Rhonda yelled at me and I asked the paramedics to bring her over. She volunteered to take care of the dogs and gave me her phone number. Frikken toe nail.
The pain soared while enroute. I don't remember much of the emergency room, and through the night vaguely recall an IV port being hooked up, blood draws being done, and the minutia of hospital admission. In the morning a team of doctors showed up. My right leg's calf was roughly 3 times normal. The verdict: cellulitus. The cause: the big toe nailed by the clipper. The wound had caused the infection. Frikken toe nail clipper.
Two days later and I was ready to leave the hospital. The pain was managable, the nurses were great [take a deep bow nurses on 6D], and the doctor kept me well-informed. He wanted me to stay at least another 24 hours. I wanted to go home. I did. Big mistake, there.
After 3 days at home with my leg up the whole time I had an even larger calf to show for it. The pain had returned. I drove myself back to Portland VA this time. More good doctors backed up by the first team, more great nurses [this time the nursing team on 5D - when you see that many good nurses in one hospital, it points to good management], and a technical support team the doctors actually listened to. I got a series of antibiotics, pain killers - some of which were narcotics to which I objected and taken off as soon as possible - and just awful food.
Another 3 days of IV antibiotics produced some positive results, but the swelling in my leg and the pain resulting from it made me cantankerous. My doctor decided that I was healing fast enough that he could send me home - but not discharge me. I would have home health care.
VA has home health care?
Who knew?
Within two hours, if I recall correctly, I got a call from VA Home Health Care. I was told to get my feet up and a nurse would be out to install an IV port. Within the next hour, not only a nurse showed up, but so did a Doctor.
Yes, a VA Doctor made a house call!
I still am amazed.
The next morning a phlebotomist came out before breakfast to do a blood draw. He was followed an hour later by a nurse. She gave me a 30 minute infunsion of antibiotics, took my vital signs, and checked my med supply - all from the comfort of my favorite chair. Rinse and repeat for the next 5 days. Two nurses were involved - one during the week and the other on the weekend. They were great to have in my home, and they couldn't have been nicer. They never left without reporting my condition to the doctor on call. After 7 days of the Home Care Program, I was on my own - almost.
Once the 7 days of infused antibiotics had been administered I was switched over to an oral one - in this case ciprofloxacin [cipro]. I still had pain from the swelling and was put on Vicodin. I was given a week's supply of both drugs and told to stay off my feet. That was no problem - the swelling and attendant pain although easing was still there. Apparently there are no quick fixes for cellulitus.
As I was taking the last of the cipro, I called my primary care doctor to find out what to do next. The pain was still there and so was the heat coming from the infected area. He sent me to the VA's emergency room.
Emergency Room Hell
That experience was so unique that I will cover it in another diary. As far as how I'm doing now, I still have swelling in the leg, and the pain is managable. That brings you up to date.
The take-away for you who are NOT veterans
The Veteran's Healthcare Administration - what we typically refer to as the VA - is what the wacked-out right wing fears most:
- It's government controlled
- It works - and in this case, works better than the private sector
- It provides a continuum of care that is the holy grail of health care
- Because all of what I have experienced is related to my disabilities [diabetes, neuropathy in my feet, and one large pin which holds together my right ankle] none of this treatment has cost me a single penny - except for three of years of military service during which 58,236 of my brothers were killed, 153,452 were wounded, and 1,711 were missing in action.
If this is ObamaCare, bring it on