Prodigal Son Returns

[Larry Reese]

Attention all: I am travelling but expect to get turns out over the next to nights to all but one of my opponents. Please bear with me, and if you cannot, I completely understand.

ON THE MYSTERY WWII PHOTO in another forum here – could someone please post the answer – it’s Lucian Truscott (I believe one person has guessed it). If they’ve already moved on, that’s cool too.

As for some of barest details of the tension that’s been hardening my arteries and the joys that have been lightening me days, if you’re interested, read on. If not, stop here and save yourself!

Okay gents, here’s the story. This is an abridged version.

As many of you know, despite severe financial straits we decided to proceed with having additional children for two reasons – the excellent insurance I was paying an arm and a leg for would pay for everything, and I mean everything, with no out of pocket – and age; even though she’s ten years younger than me, my wife is at the point were birth defects, etc…, and risks to the mother begin to increase with age. So, based on these to factors and the prospect that hopefully things would improve financially during the pending pregnancy we went ahead and did it. Two wonderful baby boys came our way. Then, because my wife’s previous birth was a classical caesarean section, an early C-section was mandatory in this pregnancy too. So…

We went in to have the babies delivered by planned C-section at 36 weeks gestation on March 9, 2012. (As some of you know we were in the ER twice coming up on the delivery date after an uneventful pregnancy because of complications and how large the babies were – in the 95+ percentile, although sugars etc… were strictly controlled; looks like they were just big babies.) The babies were admitted to the NICU on that date due to their prematurity but were looking good, and my wife began recovering in her room. We first went home on the 13th, with one of the babies, the other would remain in the NICU for an additional time. That evening the upstairs AC unit imploded and soaked the entire ceiling – got the AC guys out the next day; will fix the drywall myself later.

On the 14th, with a fever and pains, the c-section incision opened and we were readmitted to the hospital again through the ER. After the highest rated antibiotics on the list and cleaning of the wound, they packed the wound with “wet to dry” dressing, taught me how to do it, and sent us home on the 16th. We arranged for home health to come by every other day or so and change the dressing and monitor the wound.

At some point, I can’t remember the date, my other son was released from the NICU.

On the 17th, less than 12 hours after being discharged we headed to the ER with my wife having trouble breathing. We diverted to a local hospital out here in the west because it seemed to be getting more serious quickly and the hospital we use in the Texas Medical Center is ~20 miles away. So, they start checking her out, CT scan comes back showing congestive heart failure. This is often a byproduct of pregnancy evidently. Anyway, fluid around the heart and lungs. We arrange for an ambulance transfer to St. Lukes in the Med Center. That evening, late, after the maternal fetal medicine specialists and world renowned maternal specialty cardiologists got ahold of the data, they release my wife saying the condition is not really congestive heart failure, but part of the pregnancy related complications they were expecting and that as long as it does not get worse it should resolve fully.

Then, on the 18th or 19th, I can’t remember which at this point, I think the 18th, we took the boys for their one week check up with our pediatrician and then to a follow up with the maternal fetal medicine specialists because the wound was not looking right. Conclusion was the wound was infected and so was the skin above it. I had been very concerned about this; having worked in the hospital environment (albeit in a legal capacity) I was very aware of it as a breeding ground for MSRA and other serious, very difficult to eradicate infections. So, I left her crying, being admitted to the hospital again, to take the boys home to my mother in law who had been helping us since the 9th. All this time I was trying to take care of the boys, my 3 year old daughter, my mother in law (who was invaluable and gave up three weeks of her life to help with all this, but was highly stressed and sleep deprived herself), my legal practice, all the other mundane things in life like selling two cars and buying an SUV so we could more easily fit all five of us and all the baby gear, and spend as much time as I could with my wife at the hospital. It was incredibly stressful and overwhelming. My father in law came in to help as well eventually.

Now that she had been admitted the fourth time, and there was the danger of massive infection, the hospital went into overdrive. She was contact quarantined, surgery and infectious disease were brought into play as well. They had already “carpet bombed” with the top of the line antibiotics on the second admission and that had clearly not worked on the bugs involved. Additional cultures and blood were taken and while these were running the infectious disease guy got permission to use some of the restricted antibiotics (evidently these are kept under lock and key so as to prevent over use and rapid degradation of efficacy by build up of resistance in the target organisms). I’ve seen a lot of wounds and infections and I’ll tell you what, I’ve never seen anything like this stuff on the restricted list. A massive infection above the wound that was angry red and hot to the touch was completely pink and fine in less than 12 hours. Amazing. Anyway, the culture came back negative for everything except proteus mirabilis and another that escapes me. These are not particularly uncommon bacteria, and are aerobes. The ultimate weapon, the carpet bomb stuff, Vank, that burned my wife’s veins and blew IVs during the previous hospitalization and which she was receiving initially during this one, should have been able to wipe this stuff out with no problem, so I am suspecting these were new, resistant strains. Regardless, the restricted antibiotic really cleaned them out, thank god. However, the wound had still been compromised and surgery had to be called for to excise the dead and damaged tissue, making the wound much larger, but clean. A wound vac was attached and eventually, after many more trials and tribulations I won’t recount, we were finally discharged from the hospital on the 26th, with a portable wound vac my wife continues to wear.

The vac itself has been a positive and negative experience. For those of you unfamiliar with negative pressure wound treatment, a sponge or foam piece is inserted into the open wound, tegaderm draped around all the wound and over the foam sponge to make an air tight seal, and then a vacuum attached to the sponge, so that it suctions out any exudates from the wound, increase blood flow to the wound area, and promotes closing of the wound by pulling the edges closer together. You wear the pump in a bag. Entire dressing has to be changed every 48 hours. Well, the last time the dressing was changed on this one, the RN did not attached the suction right and we had to have an emergency dressing change last night in the middle of the night. However, all seems to be going well at this point, with no complications from that.

The Saturday during that stay in the hospital I finally found an old Ford Expedition to buy (they sell incredibly fast in this market, sometimes in as many as 90 minutes). Good condition (it at first appeared), with all the safety and convenience features I wanted (curtain air bags, power folding 3rd row, power pedals because my wife is tiny, etc…). So, we bought that and after the 50 minute drive home, being a car guy, I noticed what I thought was a gear whine from the rear end. To make a long story short, the rear gears were shot (previous owner who bought it new towed excessive weight with it and crunched the gears good). So, had to pay to have the rear end rebuilt plus a lot of other general maintenance things (new pulleys and belt, fluid flush, etc…) to make the thing as reliable as possible given its age and high miles. In the end, I still think it was a good deal, fixed the one known issue and got a great, otherwise well kept, one-owner car. The interior, for example, is in amazing shape for as old as it is. Almost looks new. But, still, an added stressor while all this other stuff is going on, and not something we can afford to throw money at. My in-laws were exceptionally generous and helped loaned us money to pay for the Ford in total up front, so no loan.

Lastly, but not least, I am looking at buying a business in my home town (a carpet store) and moving my family (and my legal practice) there. Like small town living, always feel good to be “home”, my folks and my sister, brother in law, and nephew all live there. Downsides: less immediately available highly competent medical care; less highly competent school and play-school facilities for the children; possibility that business does poorly. Anyway, I am now out here, just sat down in the hotel, going to meet with the owner tomorrow and decide whether or not to buy the business in the next two days. If so, we’ll close immediately, and he will continue running it for me (under contract conditions) for up to two months until my wife is able to travel and we can move out here. While I can talk with her over the phone, we had counted on her being here to help with the decision making process – it’s her life and future too. We’ll have to do that as best we can by wireless now. I haven’t even had time to write the contract for sale yet; but have been able to arrange the down payment and financing. I always plan conservatively, so I hope there is a big enough margin here to make the store successful and carry us for awhile. The market is small and I’m not sure another attorney can be sustained in it; the store will allow income to be coming in and for me to pick and choose cases I believe in, rather than taking everything coming through the door. A big change going from a city of over 5 million to a town of 29,000, but if the business in person matches up to the financials and photos I’ve examined, I believe we’re going to buy. Lol, five solid weeks of stress topped off with a minor decision about the entire future of your family socially, financially, and educationally. Ha. To hell with this, I may go back to hunting and gathering. At least they got to sleep occasionally.

Best wishes to you all,

Larry Reese