Amputation Update
This Substack is about life in Việt Nam from the viewpoint of a 10-year expat who spent his first 60 years in a low-context culture.
Despite the virtual omnipresence of AI “writings”, this Substack will never use them. Everything published here uses only, unless otherwise noted, my original thoughts and words.
Privilege
In talking with a couple senior (ranking, not age) members of the staff the other day, I found myself taking offense when one of them saying that it was worse for someone to “take advantage of an amputee” as opposed to, I’m guessing, someone with a full compliment of legs and arms. I wanted to say, “it’s bad to take advantage of anyone, full-bodied or not”, but I held my tongue.
That said, I’m going to have to get used to people treating me differently because my leg’s been binned. It’s up to me to show them that I’m missing a leg, not my mind — at least not a lot of it.
Prostheses
As I’ve written before, I hope to undergo a procedure called osseointegration that allows a direct connection between the bone and the prosthesis. Since my surgeon told me that Medicare may not pay for the implant, I’m also looking at more conventional prostheses.
To that end, I recently met with a local company’s sales rep. He gave a very good informal presentation that left me feeling more confident in direct stump contact than I was at the beginning of our meeting. They make a gel mould of your stump and cast the prosthesis to that. Then they test fit it, make necessary modifications, and cast another prosthesis. When the fit’s as good as it gets, you get your new leg.
I asked what the cost of the prosthesis would be for someone without insurance, and he gave me a range of US$10,000 to $50,000. I’m guessing that the top end is gold-plated, though I didn’t ask.
To get the stump ready, it needs shaping. The rep gave me a “shrinker” to wear up to 20 hours a day.
It compresses the stump, rounding it out, as it heals. The compression is quite uncomfortable and increases the overall pain level of the stump — just something else to add to the festivities. In the beginning, the only way I was able to keep it on was taking it one hour at a time until I couldn’t stand it anymore. After about a week, I was able to keep it on for 18-20 hours each day without much thought.
Pitiful?
When I was at Cedars-Sinai (LA) for the second revision (May) in four weeks, I mentioned to Dr. Paiement that if this revision — #7 — didn’t work, it would most likely be time for an amputation. He told me that at my age, an amputated leg would mean that I’d be confined to a wheelchair for the rest of my life.
Now that I am a 72-year-old amputee, I am determined to prove him wrong. Me in a wheelchair equals me pretty much confined to my house for the rest of my days, and that’s NOT going to happen. To that end, I have an hour of physical therapy (PT) six days a week and do exercises outside of PT. They tell me I’m progressing better than expected, so there’s hope. I am already getting around on crutches for short distances, though I am using the wheelchair for longer jaunts until I can build up my stamina.
Personal Hygiene
Rehab center policies allow for two showers per week per patient. My days are Wednesday and Saturday and since I’m stationary most of the time, it’s not as bad (smelly) as it could be. There’s a PVC chair in the shower, so I don’t need assistance to clean myself. I am, therefore, am not limited to two-a-week. I manage most weeks to stash a towel and wash cloth so I can add an additional shower or two.
It could be a lot worse…. a good number of residents here wear a diaper and have to be bathed in their bed.
I normally get my hair cut every three to four weeks. It’s now been three months since I sat in a barber chair and 10 weeks since I shaved. I hate shaving, so I’m enjoying the beard.
Then there’s the Ted Kaczynski look-alike version:
I’m liking the beard, though I’m betting that once I get home it’ll have a short life.
What’s next?
The next step is inserting the “sleeve” that will eventually hold the post at the top of the prosthesis.
They could do the implantation surgery as soon as the end of this month, though when I take into account what Medicare will cover, that’s too soon.
Medicare covers a “Benefit Period” of up to 60 days in a hospital and/or rehab facility. On day 61, the patient has to pay $419 per day for the next 30 days ($12,570 per month) and $838 per day starting on the 91st day ($25,140/month). After day 120, the patient covers everything.
YIKES!
When I leave here to fly home, I will have used 57 of my 60 days in this Benefit Period.
The good news is that the Benefit Period ends when you’ve not received in-patient hospital or SNF care for 60 consecutive days. There is no limit to how many Benefit Periods you can have, though each one incurs a new deductable payment.
My 60 days without hospital or SNF care in this Benefit Period ends on 15 January. The implant surgery is scheduled for 22 January, and my new Benefit Period will begin when I check into the hospital on the 21st.
Heading Home
After checking out of the rehabilitation center next Saturday, I will take an Uber to a hotel near the West Palm Beach airport and then an early morning flight out the 16th. If all goes according to plan — which will have a chance if the government shut down ends before then — I’ll arrive in Saigon about 11 p.m. next week Tuesday,the 17th.
La will meet me at the airport to help me manage luggage, etc., and we’ll fly to Dalat on Wednesday. I will then start figuring out the chapter that’s my new one-legged life.
This chapter will most likely involve a lot of hanging out at home and manuevering either on crutches or a walker. Can you guess how glad I am that I designed our four story house with an elevator?
Good!!!! Travel well!!
It's good to see you bouncing back, I honestly didn't imagine you in a wheel chair after this, I always assumed you'd find some way to get back to walking. I like the beard, but I take it that beards aren't popular in Vietnam?