Category Archives: HANDICAPPED

LOST IN TIME…LOST IN SPACE

 

Toward the end of July, 2011, I began having back and abdominal pain that progressed from mild to extreme.  Four trips to the emergency room at McGuire Veterans Hospital provided no relief.  In desperation, and to avoid a wait time in the ER, on July 28th, I called an ambulance to pick me up at home.

Somewhere, during the trip to the ER, my mind went blank. I have no memory of being admitted to the hospital.  I have no memory of staying six nights.

My medical records show that seven days later, on August 3rd, I was transferred to Sitter and Barfoot Veterans Care Center.

Sitter and Barfoot is a veterans’ long-term care and rehab center. I had never heard of it.  I have no recollection of being included in the decision process. No family members participated in the decision to move me to a nursing home.

I’ve been told that I was discharged from McGuire on my own and arrived at Sitter and Barfoot by taxi. I have no memory of a cab ride. I completed the admitting paperwork but don’t remember doing so.

I have vague recollections of being in unfamiliar surroundings, being restrained in a bed at night with bolsters on both sides and with an attendant.  I have no idea why I was restrained other than being a possible flight risk. Staff members have told me that I was aggressive, delusional, and hallucinating.

In September, seven weeks later, I was scheduled for back surgery, returning to McGuire for a laminectomy at T-8 and T-9 vertebrae. I have no memory of the discharge from Sitter and Barfoot and being readmitted back to McGuire. The surgery was performed on September 22. I have been unable to stand or walk since.

My medical chart shows that on 10/26/2011, Kathryn L. Hall, a social work student wrote:  “When asked about his IDT [interdisciplinary team] meeting yesterday, the patient said that he understood he would not be able to return home, but hopefully will be able to return to Sitter & Barfoot.”

It remains unclear who was “hopeful.”

Ms. Hall was under the supervision of Thomas Olivieri, MSW.

I stayed at McGuire Hospital until December 9th, 2011, receiving various antibiotics, therapies, rehabilitation, and consults from a variety of medical disciplines.

Returning to Sitter and Barfoot was the only option offered, and I knew of no other comparable facility.  My previous experience at Sitter and Barfoot was unremarkable.

The social workers at McGuire glossed over the fact that I would have to switch from being treated under the Veterans Health Administration and change to Medicaid. I would lose all of my possessions; all retirement income less $40.00/mo personal needs allowance, and my best friend.

Even though the prognosis was grim, I remained optimistic about the future and refused to accept the fact that I would never walk again.

I did not comprehend the long-term consequences regarding the direction the social workers pushed me.  In retrospect, the options presented to me were end-of-life decisions—at the young age of 69.

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I will spend the rest of my life in a nursing home where if feel constrained. I was coerced into a controlled environment and had to surrender my independence; placed in a closed social structure that was foreign to me. I found myself surrounded by persons, not of my choosing, many experiencing cognitive decline, some inconsiderate, and others too loud for my liking.

The few residents that I had formed a friendship, sadly, have died. I stopped trying to replace them.

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Residents are encouraged to decorate their rooms for a personal, home-like feel.  Social activities offered are designed to entertain and provide a distraction for all age groups and abilities: Scattagories, Pictionary, Bingo, Trivia, Dominos, art classes, current events, music, etc.

Often residents remain alone with their thoughts, blankly watching TV or staring out at emptiness trying to recapture fading memories.

These conditions serve as a view into my future.  These conditions are what I will become. It is all too clear.  This is what I have to look forward to. It’s not a pretty picture. Those around me are in some stage of slow decline. It serves as a continual reminder of the futility of it all.

*

Through education and perseverance, I prepared myself to regain some autonomy that was initially denied.  I have been able to expand my boundaries and travel to downtown Richmond by city bus.

Although Richmond is a friendly city for those with disabilities, the bus schedule is less accommodating. Destinations of interest often require transfers and long waits. Weather is a major consideration, requiring advance preparation, often forcing a disappointing change in plans.

My independence is limited by my power wheelchair, city bus, and economic constraints. Still, I take pleasure in the occasional excursion downtown. My ability to come and go is hampered only by my physical affliction, financial hardship, and climate conditions.

*

I have a private room. I have my laptop. I have my music, and I am left alone to pursue the only thing of interest—writing.

I hope, as I move forward, my thoughts and opinions will reach those that share the same interests.

 

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ANOTHER DOOR CLOSES

OPINION:

VETERAN

Another door closes.

I requested a physical therapy consult through my outpatient nurse at McGuire VA Hospital.

McGuire VA MEDICAL CENTER

What I was looking for was a comprehensive physical therapy regimen to improve my lower body strength so that I may regain more independence.

The consult was set up with Laurel Hackett in the physical rehab department at McGuire.

Immediately I was aware of her reluctance in accepting my objectives as realistic. I received no encouragement or support. She just gave me reasons why my best opportunity for success was immediately after a spinal cord injury; not 24 months later. No one explained that to me at the time of the injury or in the recovery process.

The second visit I actually got into the standing machine. Laurel took measurements and monitored my blood pressure while increasing the vertical positioning. The session was punctuated with interruptions, moving of equipment, and concern for a patient who had taken his power wheelchair on a tour of the hospital.

Laurel had requested that I provide her with a list of the exercise equipment available to me at the nursing home, Sitter and Barfoot Veterans Care Center. On the third trip, I gave her the list.

SITTER AND BARFOOT SIGN (2)

Laurel began making inquiries as to why I hadn’t approached the therapy department at the nursing home for my physical therapy needs. I explained that there was a communication issue, lack of credibility and void of any enthusiasm or encouragement. She then began to distance herself more. It was clear that she was developing a conversational exit strategy.

Laurel mentioned the fact that perhaps we were “re-inventing the wheel” and that I would be better served talking to a therapist at the nursing home. She persisted to the point that I picked up my list of equipment, and I began to close our conversation.

She made several attempts to regain control of the conversation as I was leaving, but it seemed we were going nowhere.

I left McGuire VA Hospital more disappointed and discouraged as ever and returned to the nursing home.

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THE EXIT DOOR

OPINION:

VETERAN

The reality is, for most people, nursing homes are repositories for those wasting away, waiting to die. No matter how hard nursing homes try to defer the attention away from reality, reality always returns in the lonely hours of solitude.

SITTER AND BARFOOT SIGN (2)

Having been placed in a nursing home prematurely is a frightening, frustrating, and depressing condition thrust upon me unwittingly.

My orientation contained carefully crafted dialog which omitted the term “nursing home.” In fact, those words were never mentioned when discussing my treatment, therapy, or future. It was always referred to as “the Veterans Care Center.” I had no idea I was being cast aside like waste.

My last memory in late July, 2011 was traveling down Hull Street in Richmond, Virginia on the way to the emergency room at Hunter Holmes McGuire Veterans Medical Center.

I remember waking up several days later in bed at Sitter and Barfoot Veterans Care Center after being admitted on August 3. I had never heard of the facility. I didn’t know it was a nursing home where people were left to die. I lingered and languished at the Veterans Care Center in a daze, in and out, with only vague memories of what transpired.

Seven weeks later I was told I had an abscess between T-8 and T-9 vertebrae which was putting pressure on my spinal column caused by the MRSA (Methicillin-resistant Staphylococcus aureus) bacteria. I was transferred back to McGuire Hospital where the VA Medical Center performed a laminectomy on September 21.

I am now a paraplegic confined to a power wheelchair for the rest of my life. I have not walked since the surgery.

After the surgery, I was an in-patient at McGuire Spinal Cord Injury Unit being fed medications through a peripherally inserted central catheter (PICC) until early December.

During this time, my memories are vague, but I do remember some of the nightmares vividly. Most were about the hospital room moving, losing my balance, and the fear of falling.

I was coerced and led through administrative doors that permanently closed behind me. There were no alternatives offered, no turning back. I was ushered through a bureaucratic maze filled with omissions, half-truths, and misleading information. I was never told I was being transferred to a “nursing home.” It was always referred to as the Veterans Care Center or it was for continued “rehab.” No one alluded to the fact the move was permanent.

I was told I needed to provide the VA my “financial records” for Medicare to facilitate the transfer. I was never told details about Medicaid or the ramifications.

Those revelations would not come until December 19th.

I was transferred back to Sitter and Barfoot on December 9, 2011.

All during this time I had only the clothes on my back and $41.00 when I got into the ambulance back in July. During my stay at McGuire, I received some books, and my neighbor brought my laptop from home. That was it!

I was to learn later that was all I would be left with; $2,000.00 after the required “spend down” after a lifetime of work. Several books, a laptop, the clothes on my back, a pair of Sperry Top-Siders plus $2,000.00.

In just over a week, I would find out I would be either homeless or hopelessly and forever in debt.

Below is an excerpt of my progress notes from the VA dated 09/21/2011 on page 630:

Plan:
Epidural abscess & Back pain: The source is probably the bovine valve which was replaced on March [30th, 2011] since there is no other obvious cause of abscess in this otherwise healthy gentleman. No history of pneumonias or admissions for sepsis. No hx of IV drug use.

The bovine heart valve surgery was performed at McGuire Veterans Medical Center.

This is what the Veterans Administration can do to you!

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“FREE AT LAST! FREE AT LAST! THANK GOD ALMIGHTY, …”

TESTING THE TERRAIN:

VETERAN

My purpose for taking my first ever bus ride* was to test the friendliness of Richmond to the disabled and wheelchair bound. And too, occasionally escape the controlling confines of the nursing home.

My interest in public transportation extends back to over a year ago. I was exploring the possibility of using the Greater Richmond Transit Company’s (GRTC) CAREVAN. The CAREVAN would allow me to travel the Richmond area, point to point, at a reduced rate of $2.50 (now $3.00) one way.

The CAREVAN seemed to be a convenient way to get from point A to point B when using a power wheelchair. It is cheaper to ride the fixed route city bus. I based my reluctance to use the city bus on the mistaken belief that Richmond was unfriendly to disabled persons.

I had my reduced rate GRTC card for over a year and I  only used it once. That was a pleasant experience dampened only by the fact that it required 24 hour advance reservation. The need for a reservation reduced the excitement of a spontaneous trip to downtown Richmond.

Then I heard that someone from Recreation Therapy at McGuire Veterans Medical Center was going to try taking the city bus a mere four tenths of a mile, across Hull Street, to Southside Plaza. Hull Street has no pedestrian crosswalk making it impossible to enjoy an Egg McMuffin and a decent cup of coffee at McDonald’s.

Having the location and the approximate bus time, on a whim one mid-morning, I went across Broad Rock Boulevard to the bus stop on E. Belt and waited. When the bus stopped, the doors opened and a ramp extended to the sidewalk, I asked the driver if the bus went to Southside Plaza. He acknowledged that it did and I got on the bus. The return trip was equally uneventful. The trip gave me satisfaction and a great feeling of accomplishment. I have since taken the city bus downtown.

I have given up any hope of understanding  GRTC’s bus schedule. I started using my computer and the GRTC website to navigate through the city of Richmond.

My third trip took me downtown to 7th and Marshall. Once again, the trip presented none of the horrors that I had anticipated. In fact, on this trip, I found just the opposite. Sidewalks and crosswalks, although bumpy, were surprisingly easy to navigate.

Circling the block downtown, I noticed a sign on a window on 7th Street, “Richmond on Broad Café.” How excited can I get? Anyone who knows me knows how I am about coffee shops. Coffee shopping has been my hobby and passion since retiring several years ago. Give me a coffee shop, laptop, warm atmosphere, good food, and I am happy.

RICHMOND ON BROAD

The café proved to be one of those wonderful places in Richmond. The wheelchair access is on the Broad Street side and very easy to enter using the ramp. It opens at 7:30 a.m. on weekdays. I was just a few minutes early and waited for the security guard to unlock and hold the door for me,.  It wasn’t necessary, but his effort was thoughtful and appreciated.

The café was not crowded and easy to navigate towards the counter to place my order. The spacing between the tables was sufficient to find a place to put my wheelchair. There didn’t appear to be any tables designated for “Handicapped,” but the chairs were not difficult to move. Having moved the chair and adjusting my foot rests, I was able to get close enough to the table to be comfortable while eating.

I approached the counter and was immediately struck by the breakfast items in the display case. I was  taken back by the pre-prepared items but was still tempted by the display. I ordered a bacon, egg, and cheese on a croissant and a large cup of coffee. When placing your order, they ask for your first name and give you a buzzer to let you know when your order is ready. Since it was early my order was ready before I finished preparing my coffee.

The cream and Sweet’n  Low were easy to reach in a wheelchair. Napkins are on the table. Returning to my table that I had claimed with my hat, I opened croissant sandwich,.  It was hot,  and I was surprised to find a tomato hidden somewhere between the crispy bacon, provolone cheese and egg. The fresh tomato added flavor and moisture that separated the typical breakfast sandwich to a terrific breakfast sandwich.

The décor of the cafe  celebrates the location as being part of the University of Richmond’s downtown campus. Exposed brick dominates one interior wall, but does not detract or diminish the overall warm and welcoming feeling. The floor is tile that makes for easy maneuverability in a wheelchair. The fixed seating is cushioned, making it comfortable for those wishing for long conversations or as a meeting place. The outside view is pleasant with a parade of workers going to their jobs.

The return trip begins at 8th and Marshall, which is right around the corner from the drop off point. At my home destination, I exited the bus at Horner and Broad Rock near the south gate of McGuire VA Hospital. At no point did I feel the least bit uncomfortable and I was surprised by how friendly Richmond is to those of us in wheelchairs.

* NOTES: In my case, both buses, down and back, came a little early. If you have questions, ask the driver before getting on the bus or you can call GRTC Customer Service @ 358-4782.

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