What is a weekend?

I wore this shirt on a weekend.

In a delightful Downton Abbey dinner scene, Matthew Crawley announces his new job as a lawyer. Job: faux pas #1 to the royals. Alarmed, the Earl of Grantham reminds Matthew of his role in running the estate. Matthew casually asserts that he can fulfill those duties on the side, nights and weekends. To which Lady Violet perks up and asks:

But what is a week end?

Some quick internet research raised questions about the scene’s accuracy in the context of that time period. I’m committed to this interpretation: if you don’t work a job, “weekend” has no meaning. These days I can relate.

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Health roundup

I’m completing a month’s long hospital stay to treat the infection on my right lower leg. Ten days, 1 surgery in the hospital. Twenty days, 1 surgery in the rehab hospital.

I will require thrice-weekly wound care for months until my leg is healed enough for a skin graft.

The ulcerative colitis is slowly improving but not yet cured. I’ll return to the gastroenterologist to plan next treatment steps.

I’ll also return to the oncologist for next steps. I’ve completed the immunotherapy for the cancer and will be scanned for any new cancer. I welcome all prayers that there is no metastatic activity lurking about.

Really miss these two.

Protecting myself

Treating my leg infection has become priority one, even over the colitis and the cancer. Over the weeks since July 9, I observed the extent of the infection. I understood that treatment would include antibiotics, debridement, and wound care. How long would the treatment take? What about pain? That all went into a box with the label: To think about later.

The night before the debridement surgery was later. Bunches of disturbing thoughts came tumbling out. I went from feeling safe to contemplating what amputation might be like. To counter the frantic thoughts, I sat up on the edge of the bed and did some box breathing: inhale for 4 counts, hold for 4, exhale for 4, hold for 4, and repeat. I decided to bring every concern to every member of my care team the next day. Then I did an hour’s worth of German Duolingo.

The next day, my care team answered my questions with reassurance. My primary question was whether dense areas on my leg were dead tissue. Not likely because areas of redness were not spreading and my vitals did not indicate that I was fighting infection. I didn’t have a fever, elevated white blood cell count, or trouble breathing.

The surgery itself was uneventful and my new wound vac and I were back in my rehab room for dinner.

The fascinating world of wound care

Wound care often involves treating eschar that forms over the wound. Eschar is quite a beast. Here’s an explainer:

Eschar is a type of necrotic tissue that can develop on severe wounds. It is typically dry, black, firm, and usually adhered to the wound bed and edges.

The area of eschar on my leg was particularly large at 5x4 inches (12.7x10.2 cm). Every wound care specialist has examined my leg with curiosity. The profession is clearly a calling, and I welcome their passion.

After the surgeon removed the eschar during the debridement, he placed a wound vac over the area. This is my new BFF, continuously removing fluid through negative pressure.

My next moment of startling and disturbing clarity arose when I asked:

What healing time frame am I looking at, weeks or months? Reply: months.

I will need to have the wound vac replaced on Mondays, Wednesdays, and Fridays, a big time commitment. More important is that I cannot stray too far from Austin. This hit me hard. Not to mention that the replacement process involves painful cutting, poking, and prodding.

Physical therapy works

Removing the eschar increased my range of motion. Still, when I first stand after longer periods of inactivity, my leg is stiff and my heel struggles to reach the floor. Walking slowly always helps. Oh, and I’ve graduated from wheelchair to walker to cane. Walking with a cane requires a lot of concentration. Focusing on my form and exercising my baby-sized muscles tires me out. Initially, I was all about powering through, trying to maximize my exercise time. Today, I respect the level of effort required and try not to overdo the physical activity.

Napping and meditation are priorities 1 and 2

I will need to be ever mindful of my current physical limitations. Case in point: To prepare for returning home, I created a daily plan of activities. My first draft put working out at the top of the prioritized list, with napping at the bottom. How very Leah-like and unrealistic in thinking that I would ever be able to finish all the tasks and score a nap.

My second draft has napping and meditation at the top.

😴

A moment of Bun