Wednesday, July 8, 2020

Losing It

Heavenly scent of the Ylang Ylang 
When I look back at the post immediately prior to this one, it seems like it happened so long ago.  Things started out so well.  Sure, the initial two week duration of the lockdown due to the Novel Coronavirus that causes COVID-19 was extended... and extended again, and again.  But we were making the best of it.  I had us eating healthy foods, maintaining the weight loss plan and getting outside to exercise daily.  In fact, that was the highlight and purpose of our days.  It gave me a sense of control of the situation that kept my mind from spinning out. It's all a blur now.  The only way I can make any sense of it all is to go through the photos. 

End of March into April...

Happily walking inside our courtyard

We walked every day.  We began inside our courtyard, and mostly walked in the cool of the evenings when there was some shade from our buildings.  Then we got tired of that view and moved our walks to the outside perimeter of our condo property and found that walking in the cool of the early morning was preferable.

I began to look for the beauty of the little things all around us.  There was little outside stimulation for our minds, so our whole world zeroed in to this little patch of coastline.  My need to take photos could not be squelched.  No matter if the subject matter was sparse, I found something to take pictures of each day.  

The fact that we live on a tropical island where beautiful flowers bloom year round became more evident as my eye was forced to seek beauty in a more limited space.

We grew hyper-familiar with the position of the sun, and enjoyed the occasional passing rain shower. No need to go inside, it will end soon enough and we'll be refreshed and maybe catch sight of the rainbow-de-jour!

Tiny white bougainvillaea flower

Moonrise through the palms

A pair of St Lucia Orioles have come to Arroy

Rainbow de jour

Taking cut flowers home in the falling rain!

I did a LOT of online shopping from ThredUp

We literally sat outside waiting for the post man so we could get our many packages!

We stared longingly at the beach just outside our wall...

Local poachers don't follow the rules!

I stood in long lines waiting to get into the grocery stores.

I pruned my Texas Sage shrubbery.

But walking only took up an hour or so each day... what did we do with the rest of our time?  With the news running on a constant loop about the COVID and other signs of a world gone mad, we tried to make sense of it all.  Obviously we can't go out, so we have to figure out things to do inside.  The one obvious thing was cooking.  It became a challenge to cook things that could keep my diet happy.  Add to that, we tried to help the local economy by seeking out island growers and producers.  I signed up for island grown food delivery for a while.  I really tried.  I even made a few things with plantains and papaya that were outside of my comfort zone, that actually turned out pretty good!  

Farm fresh and delicious!

Might as well make enough for leftovers!


Mashing plantains for Mofongo

My Mofongo stuffed with island raised beef!

Once the argument over whether or not it was safe, and/or required that we should wear face masks when going out in public, I dug out my material scraps and sewing machine, and went to work making masks for us.  I even cannibalized a tie-died shirt that I never wore and made some really fun ones!  This took me several days!

Plenty for us and some to share!

I love the way the tie-died masks turned out!

Talk shows began producing from their homes... and even their bathtubs! Bizarre!

More BIZARRE!  Why did we find this when cleaning out our storage closet???

We were doing well.  We were staying positive. We had plenty of things planned to take us into the next extension of the lockdown, and the next...  Then one morning when I was just getting started on a house cleaning binge... I fell down the last four stairs while coming down with the trash.  

One moment I was boppin' on down the stairs, and the next moment I was lying on the floor.  I froze.  Bruce ran to my side but I just wanted a moment to take note of my situation.  Cautiously moving parts of my body to see if anything was broken... I realized that my feet were not good.  I tried to get up off of the floor and found that I could not put any weight on my right foot. 

It's all a blur now, but we ended up calling 911 with the help of a neighbor, and the ambulance came to get me.  It's ridiculous really.  We could have had a neighbor drive us, but because of COVID, my insurance advised calling the ambulance. 

This is where the wheels fell off of my sanity.  

Doesn't look like much but DAMN that right foot HURT!!!

This became my world.  Watching movies about walking the beach....

You know that I always try to be positive and give people the benefit of the doubt. (Until I don't)  But in hindsight, I was really failed by the medical system here in Puerto Rico.  A big part of that was due to the shutdowns with COVID.  By this time, most of the island was under a strict stay at home order.  All non-essential businesses were closed.  This meant that MOST doctor's offices were closed and only practicing telemedicine for existing patients.  

No new patients.  

My first visit to the ER was a joke.  There was nobody in the ER besides me, and I still sat waiting.  I got an x-ray and it came back negative.  The doctor NEVER even looked at my foot.  Just before I was wheeled out, a nurse came over to me with a prescription for anti-inflammatories and a syringe.  They were going to give me a shot for pain (um NO thank you) and send me on my way without ever being examined.  I refused and left. 

Two weeks later, after much misery from constant pain, swelling, and mental anguish, I called my insurance company to see if they could advise me who I could go and see for my foot.  I had already called a couple of doctor's offices from my provider list and was told they were not taking patients.  The insurance told me to go back to the ER.  This time, I had friends drive me to the Mennonite Hospital ER.  The first time I went to the one closest to my house that was chosen by the ambulance service. 

With much hope for some answers, I went in and waited in a wheel chair (feeling like an idiot) and told my story to three people with lots of waiting in between.  Finally they sent me for another x-ray, then after more waiting, here came a nurse with another damned syringe for pain meds!!!  WTF is it with Puerto Rico and pushing the injectable pain meds!!!  I began to have a silent melt-down sitting there in that little room while the nurse went to fetch the doctor to deal with my refusal of the injection. I was thankful for the mask, both for covering my face to hide my tears, and also because it gave the tears somewhere to go. 

The doctor came in and inquired incredulously as to why I was refusing his order. (maybe I'm not the most compliant of patients) He had not examined my foot.  He hasn't got the x-ray results, which of course came back negative again, and yet, he wanted to send me on my way with drugs.  Just NO!  He literally asked me what I wanted him to do.  I told him that I wanted an MRI to see what other damage was done because my foot was horribly painful, discolored, swollen and not working!  He said he couldn't order that, but advised that I see an orthopedic surgeon, and sent me home.

I called that orthopedic surgeon and was refused an appointment.  Over the next few days, and weeks, I cried a lot.  I tried to suck it up and be patient. By this time I was just mentally worn down from weeks of constant ache and creeping fear.  I could not advocate for myself and I had nobody to advocate for me.  I was struggling with the language barrier as most of the medical office workers had little or no English, and with my mind in a fuzz, I just couldn't manage the phone calls in Spanish.  I tried calling my insurance company again for a list of doctors to call.  There is a nice woman at my plan who speaks English, the only one I could find who does... she even tried to get me an appointment with an orthopedic surgeon.  They were just not taking new patients.  She finally called me back with an appointment with a primary care doctor.  By the time I got to see him, five weeks had passed since my fall and I wasn't feeling much better than the day it happened.

But my spirits were buoyed up by the fact that FINALLY I was able to talk to someone.  The doctor began to take over my total medical care, as a PCP should.  He actually examined my foot, and assured me that there was nothing torn inside.  That had been my big fear.  I worried that I had torn a tendon or something and that it was going to "heal" wrong. (The mind... and the internet... is a terrible thing when one is left to one's own devices for too long)  He moved the foot around, prescribed more anti-inflammatories, and referred me to a Physical Therapist.  

That took another two weeks...  During that time, I vacillated between hope and despair.  It seemed that as time went on, the constant ache and swelling created a fear that crept in and took over my mind.  I was sad because I couldn't do anything for myself.  I was sad because I had to inconvenience my friends to take us to to the grocery store and to our doctor's appointments, which always took hours!  I was sad because poor Bruce had become my slave, and I have to tell you, while I tried, I wasn't always successful at not snipping.  I was in pain and saw no end in sight.  How could it just go on like this???

This is my celebratory toast to opening the pool!
Then something wonderful happened!  While I was waiting impatiently for the visit with the physiotherapist, the COVID restrictions for the island changed.  They opened the pools and beaches!  While a beach walk was not possible for me, I was able to crutch on down to our pool!  We began to spend several hours each day either lying poolside reading the kindle, or actually getting into the water for some much needed physical activity!

My life

Bruce resumed his daily swims

Minor technical difficulties

Social distancing with my neighbors!

Finally the appointment day arrived, I was really hoping for some definitive information from the Physiotherapist.  He did actually examine my foot.  He seemed concerned that it was now about seven weeks since the accident and I was still swelling and painful. He felt around on my foot and in fact, found one of those really painful spots.  He looked again at the x-ray and HE said that there was a break.  He did a lot of eye rolling, and told me that if I had come in six weeks ago, the foot would have been casted.  (I just can't EVEN...) He ordered the long awaited MRI.  And then I waited another week to get that!!!  

But I was feeling positive that I would finally get the answers I needed to squelch my doubts.  I was mostly upbeat, except that I have developed a sort of pattern.  Two or three days of positive thinking, followed by one day of wallowing in self-pity.  It works. I got the MRI and the report confirmed that there were two non-displaced fractures at the base of my 2nd and third metatarsal bones. (See, I told you I was sick) There are also bone marrow contusions that, with an internet search, explained the deep aching in a couple of spots.  Well at least now I was getting somewhere.  Unfortunately, the internet told me that it could take up to 6 months for the bone contusions to heal!!!  Another dip in attitude to follow...

Before the next visit with the physiotherapist came a followup with my PCP.  He prescribed more anti-inflammatories, and told me to start trying to bear weight on the foot.  Two days later at the PT office, he advised about half a dozen things, including moving the foot and trying to begin weight bearing, buying a walking boot, maybe taking Rx meds that they give amputees for phantom limb pain!!! Wait, what?  You think my pain is in my head!??  How do you explain all of this swelling then?  Yeah, not taking that.  Stop just trying to throw medications at me.  Oh, and he also said to stop taking the anti-inflammatory drugs because they can impede the healing process!!!  The visit ended with yet another referral to an.... orthopedic surgeon!  Well, great.  Back to square one.  The Cam Boot was a no-go. I went to try to get one, and couldn't even put my foot into it because of the excruciating pain.  

Another disheartening week during which I tried to get an appointment with the ortho... finally got one... wait another week... More ups and downs, but lots of pool time.  It seems that I can go two days of trying to hobble and swimming in the pool, then I sit out for a day or two with swelling and increased pain.  More crying. More sucking it up and trying to be positive... 

One day, my wonderful neighbors threw together a beach picnic!  Kim texted me an invitation and we were thrilled to accept.  We loaded up the wagon and went out to make ourselves a little camp.  It was a lovely afternoon, even with the passing rain!  Kim made us delicious food and we enjoyed a little bit of almost normalcy!  We are so fortunate to have this beach at our doorstep!  

Laid the kindle down on the sand and the cover magnets found metal!

Brunch at Sweet Cakes in Salinas
We had such fun that day!  I'm so thankful to Kim!  (And Sue has been there for much needed moral support.) Kim has been driving us in our car (she has a Mini) to shopping and even took us to Sam's Club one day!   Just driving the roads is something we've sorely missed!  We stopped at one of our favorite bakeries for brunch on the way.  This was the first time we've eaten out since March.  It's now June 16th!!!  Time is passing... I began to have better good days, followed by not-quite-as-bad bad days... so there's that...

View from my window as the Saharan Dust blankets Puerto Rico

Exercise sesh in the pool. I get out there and tread water for half an hour.

Just hanging out, whiling away the hours...

I have lost 25 lbs!

Puerto Rican seasons are marked by the bloom of the Flamboyan

Record Saharan Dust layer causes respiratory issues.  Had to cut pool time short a couple of days

I'm really trying to put some weight on it.

I just love the orange "snow"!

So during this time, June into July... we fell into a pattern of pool days, grocery shopping, and waiting for the next doctor's visit.  

One day there were horses on our beach!

Our little Tintillo tree bloomed!!!

It never gets old...

First attempt, and fail, at trying to hunt sea glass...

I almost fell down, but hurt my foot!  Guess I'll have to wait for that beach walk!

Playing a bit of solitaire...

I finally got an appointment with an Orthopedic Surgeon but we would have to go to San Juan.  Thankfully our friend Glenn was willing to get up early and drive us into the city.  What would we do without our friends?  I don't know.  I only hope that we are somehow able to reciprocate some day.

And that brings me up to date.  The orthopedic surgeon was very nice, but he seemed adamant that I need to be doing physical therapy.  He said that he is certain that the breaks in the bone have healed and that I need to be weight bearing ASAP.  So I asked him how he explains all of this swelling, that was so evident when I kicked off my house slipper and showed him my two feet comparatively.  One was kind of tan with veins and bones showing through the skin... and the other was sort of a red sausage that was swelled up so much that my toes don't touch the floor when I put it down.  

So after my consultation with the OS, I walked (crutched/limped) out of there with assurances that the breaks in my bones have healed, and that the swelling and continued pain could be a combination of decreased circulation due to disuse, or my diagnosis for the visit of causalgia

Great, so it IS all in my head!!! But I can tell you this.  If my head is convinced of something, it becomes a reality.  Now that I've been assured that I must begin walking on the foot, even though it feels like it's cracking in half when I put weight on it and it swells up like a sausage...  That I will do!  Now I have to deal with my serious lack of patience and keep talking myself OUT of trying to drive to Puri's Tiki bar for a happy hour snack!  I'll go for Physical Therapy soon, but I'm once again encouraged.  I even popped some Tylenol this morning, stuffed my foot into an oversized beach shoe while the swelling was still minimal, and hobbled down the sidewalk for a little exercise!  

I can't believe that we've been on lockdown for almost four months.  I can't believe that I've been one-legged for 10 weeks of that time... But I guess if we can't get out and enjoy the island because of COVID, this is the best time to be having a medical crisis... Unless you consider that the reason I even HAD a medical crisis was that I couldn't be effectively treated and/or diagnosed because of the COVID shutdown... It's a vicious cycle!  Just as my mind has been trapped in a vicious cycle alternating between dealing with it... and LOSIN' IT!

No comments:

Post a Comment