More than a month has passed since my buddy’s lower leg was shattered in an “accident.” For him, it’s been sheer hell. He’s normally a very active fellow; in fact he’s hyperactive, so this forced inactivity is driving him nuts.
(To see how this mess started, here are parts 1, 2, 3, 4, 5).
His orthopedist has been a godsend. By chance, we had found the good doctor just a few weeks before the mishap in our continuous search for local physicians wily enough to help us out as we assist veterans looking for decent medical consultations.
Most of the doctors hereabouts don’t write well, at least not in English, so finding this guy was great. The fact that he writes brilliantly AND he’s a brilliant orthopedic surgeon is pure bonus.
For my friend and his shattered leg the first three weeks or so was all hospital time. He had to wait for the battered tissue to reduce swelling enough for the first operation, which was devoted to pushing and pulling all the bone splinters and fragments back into the semblance of what was once a straight and intact tibia.
Two surgeons spent 5 hours getting that done using a heavy stainless steel cage called a fixator and a whole lot of X-rays to make sure the pins were going in correctly. I hear that the latest fixators are made of lightweight materials, but not so over here. Currently, my friend has about 25 pounds of metal dragging down his right leg. Or at least it drags on it when he tries to get up, which is not very often, just when he goes to the head or takes a few minutes to check his email on his PC.
He’s had to return to the hospital twice now, in fact, he’s there now, this last time because of a serious infection. The way I see it, around here, all infections are serious. In this tropical climate with the environment so laden with bacteria, those lurking nasties await the smallest chink in our bodily defenses to attack us.
In my friend’s case, he has more than a half-dozen metal pins pushed through the flesh of his leg into the bone, all designed to “fixate” the lower leg to allow proper alignment during the healing process.
Every couple of days, using a brush and a solution of hydrogen peroxide, the doctor scrubs away the clotted material from around the pins penetrating his leg. I guess it’s a form of débridement. The holes have to be kept open until its time to remove them. As far as my friend is concerned, that day can NOT come too soon. He tells me he’s been dreaming of the day a normal cast will replace the current cage-like monstrosity.
Last week, a few days before he reentered the hospital for his current round of IV administered antibiotics, I was deeply concerned because his leg was throbbing from the inside in an area that had not hurt all that much before. I also noticed his foot seemed a bit discolored and extra swollen. Right away, I knew it was probably the onset of a serious infection. The doctor thought so too, and a laboratory analysis proved us right.
I don’t know how he doesn’t have infections ALL the time considering he’s got those pins providing an out-and-out super hi-way right into the depths of his leg.
Infections scare me because they remind me of Mike, a fellow American veteran whom I once “assisted” with VA claims advice at least once or twice a week. To get my broke-legged buddy to listen carefully to his doctor’s instructions to get into a hospital for another round of heavy-duty antibiotics, and better yet, to do so IMMEDIATELY, I told him the story of Mike.
Up until his death about two years ago Mike was a fixture on Fields Avenue, which should be called “Party Avenue.” Usually from the early afternoon on you could catch him tooling about in his battery powered wheelchair scooter, and almost always he was skunk drunk by 2 p.m.
Once he had his daily buzz going he’d find a spot to park along the street and just sit there like an inebriated Buddha in the sun. He’d talk, mostly in an incoherent mumble, to anyone and everyone he happened to know or thought he knew.
Indeed, he looked like a suntanned Buddha-bum with his completely shaven baldhead and round, deeply browned tummy poking out prominently from his wide-open unbuttoned cotton shirt.
Mike didn’t sit on his chair so much as he perched up there, mostly because he had no legs, since not even the stumps of them were left. The good thing about Mike was it didn’t take much drinking to get him drunk since he was missing most of the bulk of his body.
When Mike first came to see me for help with his VA and Social Security claims I had assumed that he’d lost his legs to diabetes or to some grievous war wound, but in time I learned that his leglessness had not happened due to disease at all.
Mike had only nominal service with the navy back in the late 50s between wars, so he didn’t qualify for any veterans benefits. His only income was a small amount from social security. If not for the help he received with filling out applications from the veterans groups here in town he probably would not have received even that. In fact, that powered scooter of his was a donation from those same groups.
He had come to the Philippines for the same reasons many have come here over the years—for the low cost of living and the wonderful women. In the end, the Philippines killed him; or more like it, he offed himself, using the Philippines as the means.
The beginnings of his woes started off ordinary enough—one day he was a passenger in a trike when another vehicle struck it. Mike’s legs were injured; I’m not sure how badly, maybe some broken bones and lacerations. If he’d been anywhere back home it would have been no big deal. He would have been taken to an emergency room where they would have patched him up, indigent or not, but that’s not what happens here.
Here, if you get hurt and you can’t pay for antibiotics, or surgery, well, you don’t get them. Mike lay with in his bloody bandages in a bed in a public hospital in a large room with a bunch of other people who could not afford quality care, and his legs slowly rotted off his body. Gangrene set in and he lost them.
Luckily he didn’t die, although it’s a miracle he didn’t. I’m not sure, but I think some local Americans finally learned of his situation and chipped in to help him survive the amputations. Once out of the hospital he lived under some cardboard in someone’s carport for months, when once again, some of his fellow expats stepped in and got him some help from social security. After that, he could afford to pay a small rent and still had money enough for utilities, and more importantly to him, enough to keep him drunk for most of the day.
When I met him he was already dying. His heart was barely pumping enough blood to keep him alive and his internals were already so damaged from the drinking that it was just a matter of time before he croaked. He had a number of serious conditions that he should have been taking at least a half-dozen medications to control, but he spent all of his small income on his drug of choice—his booze.
The local embassy warden tried to convince him to let the United States fly him home to some kind of sanatorium in the States, but Mike knew he’d never be able to have his “fun” there and refused to go. In time, I learned that he had finally died.
So, okay, it wasn’t JUST infections that ended Mike’s life, but if left unchecked, those microscopic flesh-destroying bacterium WILL do a number on you. The good thing is once I told my little yarn about Mike to my friend it seemed to get him off the pot and he was back in the hospital the next morning.