Six Years On

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Sixth “Accidentiversary.” Not one of those much ballyhooed multiple-of-five years. While solemn, neither somber nor maudlin. Have been inspired and encouraged by valiant victors whose worlds have been rocked by trials far more severe, but who nonetheless press on and do the next thing. In their particular “captivities,” they rebuff despair, endeavor with herculean effort, and prosper, even if gradually — infusing those spaces they occupy in time with great dignity. Chapeau to that worthy group. Grateful for God’s mercy in granting a year of reprieve from medical issues, being able to continue working and to drive (thaaaaat’s right — keep to the sidewalk), seeing every day of the Tour de Frronze, and innumerable other provisions and blessings. For countless agents of mercy who, at varied moments, times and periods, in WIN_20150111_144252 (2)close and from afar, briefly and over the long haul, rehabilitatively, therapeutically, materially and relationally, have encouraged and helped me and my family. At the top of this list I place the lovely and heroic Alice Heidel, my eight children, my two sons and one daughter in law, my three grandsons, my sisters, Dianne Irving and Sue Heidel, Queen Granny Cakes, and my Uncle Sonny and Aunt Chris. All others are in a tie for first, and down stream newcomers will be next year. Life like this is still, if counter-intuitively, rich and worth living because of these trials, these provisions and blessings, and because of you all. I am and remain profoundly thankful.

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Far More Weighty and Real

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Having played on the 1977-80 Virginia Cavalier football team – well, practiced mostly – I was interestedly watching the Cavs (seldom televised anymore) play the Miami Hurricanes yesterday evening. As they hung on to a slim 6 point lead, early in the fourth quarter, they failed to score from inside the 5 yard line on third and simple. So, the necessary kicker and holder trundled out to attempt a consolation-prize field goal. The ball was snapped to the holder. The holder placed the ball uppy-downy between turf and fingertip, executing a laces-obviating quarter spin, and the kicker’s shoe impacted and propelled the ball through the uprights. Wait! A pair of penalties on a pair of over zealous Miami players — off-sides (declined) and roughing the kicker (accepted) — gave Virginia the ball again, and they scored three plays later, extending their lead to 23-7.

On the ensuing kick off, Herb Waters, a Junior wide receiver with Miami, sustained an injury that left him in a heap, motionless on the turf. My years-long honed enthusiasm for the Cavs and dislike for their opponents was suspended in an instant, I held my breath for what seemed like an NFL Films cinematic slow-mo replay. I watched with laser focus as a small army of team (both) trainers, and emergency medical technicians went to work. They double-timed it out to where Waters lay, bringing the imposing and dreaded back board with its myriad straps and cushioned but rigid triangular head blocks. Encircling the injured Hurricane, they immobilizingly positioned him for transport. “Move something! Move your foot, or a hand!,” I demanded. But nothing moved, and they whisked Waters off the field to the University hospital.

Both Virginia and Miami have soldiered on through disappointing seasons this fall. Each a mediocre team relative to season opening hopes and expectations, tilting in hopes of notching a sixth win and bowl eligibility. Sports is a universe full of lessons to be learned — lessons about sadness and disappointment to be suffered, jubilation to be celebrated, battles to be fought and struggles to be endured, the fleeting and changeable nature of success, the brevity of being on top and the bullseye worn by those who are there. At the end of the day though, sports are only sports — paling in importance to a few things that are far weightier and real.

The final score was 30-13, Virginia over Miami. I went to bed at game’s end, but restlessly replayed what I’d seen through a fitful night of light sleep. I awoke and later went to church prayerfully thinking of Waters. Home from service, and still distracted by not knowing what his condition was, I googled injured Miami player, and learned very happily his injury had not turned out to be severe, and that he had been cleared to travel home with his team.

Mr. Waters, though the outcome has kept a light wind in Cavalier bowl prospect sails, and Miami’s post season hopes are not overly promising, I and all who read this and understand celebrate your far more weighty and real win.

Dominoes, Pigs, Vacuums & Providence — Musings, Mutterings & Meditations on Wound Care

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I recently watched the televised tipping of a single domino whose toppling triggered one of those mesmerizing extended clickity-clickity chain reactions. I thought to myself, “It took some extremely patient guy with extremely steady hands eighteen hours to set his dominoes in place, only to see them reduced to rubble in under three minutes.”

Many of us seldom give a thought to our health. When synced and operational, all systems are go. Each system like a domino, deliberately designed and placed. Their collective arrangement a yet more complex system. Each domino has a designated numeric value, a specific shape, size, weight, and occupies space in relation to all the others in an intentional, intelligent way. We may go years convinced that our physiological dominoes, intelligently designed and placed, resting on their narrow short edges, balanced with precarious centers of gravity, are somehow or another immovably anchored to the floor. In no danger of upset. Ever. During these days of wine and roses, these seasons in the sun, we are like a domino designer who doesn’t realize or who will not admit that the slightest instability within, or any energy randomly and disruptively introduced from without (an intruder), will send his finely tuned complex system into (perhaps sudden) decline.

A spinal cord injury (SCI) patient’s essential physiological dominoes are skin, digestion, respiration, circulation, and the immune system. Wound care (think skin-domino) is an ongoing concern for SCI patients. A wound’s onset is usually associated with sustained pressure and resulting lack of blood flow (think circulation-domino) to a particular area — pressure sores. Wounds can also be caused by the skin coming in prolonged contact with an unpleasant erosive, such as diarrhea — incontinence sores (think digestion-domino).

Not infrequently, wounds are located on SCI patients’ “posteriors.” Having been able to adapt to my injuries, and return to work, most of my day is spent in my wheel chair, seated. For this reason, I affectionately refer to my posterior as the “money-maker.” Over the past four years, I’ve sustained both types of wound. More recently, I’ve been on a year-long wound care quest to manage one of the second type, located in the coccyx region where the sun don’t shine. Its onset in August 2012 was in a particularly yucky way in a particularly tricky location.

After several months trying to self-manage, this rank amateur admitted the need for professional help and began to frequent the nearby wound care center (not surprisingly, my lovely heroic wife was miles ahead of in this awareness, and greatly relieved when help arrived). And, under professional care, the wound began to show signs of improvement.

Things became a bit more complicated in January 2013, when I was diagnosed with temporal arteritis, an acute inflammatory condition affecting the temporal artery (think circulation-domino), which left untreated can lead to blindness. A biopsy of my left temporal artery confirmed the diagnosis, and required an incision along my left temple where Johnny Quest met Hogwarts. My graying, rakishly Race Bannon-like hairline was soon complimented by a sporty Harry Potter lightning bolt scar.

Temporal arteritis is treated with Prednisone, an immuno-supressive anti-inflammatory steroid (think immune system-domino) of which my rheumatologist grumbled, “At its very best, Prednisone is a horrible drug” (not exactly a ringing endorsement). An intruder in my case, though the lesser of other evils, one of Prednisone’s side effects is its retarding the body’s normal healing processes, and so my wound grew no smaller. Neither, thankfully, did it grow larger. Visit after visit, the professionals would exclaim, “That is one good looking wound!” while taking a picture for the record. Over the months, my Prednisone dose tapered from the initial elephant gun 60 mg. dose, to 50, to 40, to 30, to 25, to 22.5, to 20, to 15. And so, my wound began again to grow gradually smaller.

My impression of the professionals is that they’ve never met a wound whose treatment they didn’t want to “innovate” (translated: mess around with for research and notoriety). I once had a pressure sore treated with electrical stimulation. Yes sir. Two electrodes, left buttock, on either side of the wound. To improve blood flow to the area and speed up the healing process. My picture made it into the ranks of medical text book photos. I knew I should have gotten that gluteal tattoo of a 53-tooth chain ring with “CFH Loves AMH!” in the middle.

My current wound has been filled with acellular porcine (as in pigs) skin tissue that is intended to encourage the further closing of a wound. Like a rehydrated pork rind, it was characterized as a scaffold onto which the wound bed tissue can grow and be supported. The results weren’t “Ba-dee, ba-dee, ba-dee . . . That’s all, folks!” Porky Pig fine. But I did start to snort when I laughed, couldn’t wait for truffle season, and had a strong urge to sit on a frying pan.

After unsuccessfully treating the wound using reconstituted bacon, more advanced dressing combinations and changes were the order. Even after rededicating myself to obsessively dutiful weight relief and position shifting throughout the day, these did not achieve a desired result. And so, technology took center stage.

The woundcare experts next referred me to the makers of a negative pressure pump that marries vacuum physics with an airtight seal bandage. The pump exerts negative pressure, creating a vacuum which, by way of a flexible hose connected to a specially engineered, heart-shaped bandage, draws increased blood flow (think circulation-domino) to the wound area.

I received this high-tech hickey unit on St. Valentine’s Day. Present for the reveal were my new best friends, Dave the pump sales guy, Mable, the Visiting Nurse Association (VNA) R.N., and Beenie, another VNA R.N. specializing in wound care. Beenie was cheery, portly, of Asian-Indian descent, raised and educated in the U.K., and sported an East End lilt. We all paraded into my bedroom with eager anticipation. I transferred from wheel chair to bed, rolled onto my side, dropped my shorts backside to half-mast, and clinically exposed the wound. As the professionals took their places bedside, I imagined myself the subject of a new reality series “Wound Care Nannies,” or perhaps a medical drama, “SCI – Wound Care.”

Upon seeing my sacral coccyx wound, and as we discussed a wound care plan, Beenie declared, “Mr. Heidel, we’ll determine the best strategy. We will heal this wound. From your behind to my mind. A true butt-mind meld.” Her declaration, confidently spoken at the time with an evangelical tent meeting fervor, in fact has not yet come to pass.

And so, we soldier on waiting for my Prednisone dose to be further tapered, and discussing ever more seriously surgical options, followed by a weeks-long period of flat in bed recuperation. While convalescing under severe ergonomic constraints, working little if at all, and tempted to worry much, may I . . .

. . . (T)hank God and marvel I am fearfully and wonderfully made. His works are wonderful — I know that full well. I have also seen and know that one can be fearfully and horribly broken. Not what I’d have scripted. But, His ways are beyond my full comprehension. Like Aslan, He is not safe, but He is good. Though He — the Good Shepherd — appears hard to me at times and for seasons, I know He is not only good, but the fount and measure of goodness. In this season, I will seek Him, look to Him, and having failed at times, I will return to Him. Though He may have injured me, He will bind up my wounds. Though I be torn to pieces, He will heal me, for He heals the brokenhearted and binds up their wounds. Psalms 23; 139:14; 147:3; Job 5:18; Hosea 6:1; Philippians 4:12,13; Westminster Confession of Faith 5 (Of Providence):1,4,5