When waiting hurts

The surgery is hard to describe. Maybe a waterfall can paint the picture for you. I cut through the skin with a scalpel and in its wake a waterfall of inflammatory fluid gushes from the tissues. Why she had waited so long to seek help? I'm not quite sure. She said, it was because she knew she would be told she needed amputation. Understandable, yes, but I think there's more to the story.

Martha had waited so long to seek help that the black necrosis had almost reached up to her knee on the right. And though only her foot and ankle were black, withered and dead on the left, her condition had left her bedridden for so long her left knee was locked at 90 degrees. She needed bilateral above knee amputations.

Sometimes you offer amputation, and the patient and family pick up and leave. Dead foot still attached and all. Having resisted thus far, I was expecting her to put up a fight, but she didn't. Not only did Martha immediately agree and consent, but she smiled while doing so. She was almost more encouraging and supportive of me, than I was for her. As if she was there to take care of me, rather than I being there to help her.

We went to surgery, and it was a long, and rather wet case, as described with the waterfall analogy above. The suction canister at the end showed about 1200mL, which I had to immediately calm down anesthesia. Actual blood loss was significantly less. It is not normal to have water gush from your skin like a waterfall. Martha's body had lived with dead feet for so long it was starting to compromise her heart's ability to function, to even beat regularly. She made it through surgery with some pharmacological support. And then additional medications were started post operatively. She recovered well, and was proud to show us her ability to transition, turn and shift in bed as she regained strength. Her daughter was equally as sweet and kind as Martha. When I asked who would be caring for Martha at home, she stepped up explaining she was actually a nurse. (I may have offered her a job at Loma de Luz considering how kind and carefully she attended to her mom. She smiled but declined as her job is currently with her mother. Fair enough).

Martha asked if she could have a picture with me. I may never know the "more to the story" for Martha but I am thankful she came and sought help when she did. That whatever had kept her at home, in her bed, with death overtaking her feet and legs, had finally been overcome before it was too late for her heart. Sometimes it's just that. We can live without a leg or two, not without a heart.

Much Love.