A LIFETIME AT WAR: LIFE AFTER BEING SEVERELY WOUNDED IN COMBAT, NEVER ENDING DUNG

A Lifetime at War

Trafford Publishing

Chapter One

A new day has presented itself in all its splendor beginning with the allure and beauty of a breathtaking sunrise as its first rays of hope and promise streaked from over the mountaintops across the sky, chasing the dark of night away.

This small miracle of nature I viewed through my bedroom window from lying in bed. I did not witness it long though as I opted to close my eyes and tried to stop the pain in my head that woke me from the two hours I had been asleep. Between the pain and fatigue from being up all night long, fighting PTSD (post-traumatic stress syndrome), my war demons, my eye rolled easily back into my foggy head for two more hours. Now it's already pushing midmorning as I lay awake in bed, trying to decide if I am ready mentally to make an honest effort to try to get out of bed. I have shaken most of the cobwebs from my mind and am beginning to have rational thoughts. I know who I am, have scanned my surroundings and recognized where I am. I am home. To know this little bit of information is a real big relief. I immediately count this as the first real success, or positive thing, that has happened today. Knowing there will be many negative things as well, I have learned to start early accounting for each victory.

The rest of my reality hits me now. I am home. Back home from war in Iraq. Back home from a level one poly-trauma unit. Back home to put my life, or rather a life, together after being severely injured in the war.

A few short years ago, I would have opened my eyes and been able to see my entire bedroom in a quick glance. I would have enjoyed what I had seen and bounced out of bed to greet the day. Habit and a regimented daily routine would have had me waking without an alarm clock. I would have been up and gotten dressed in my sweats and running shoes and would have been standing in the front doorway watching the first rays of light shatter the silence of the darkness with its illuminating fingers and found joy in seeing the world react to the angelic announcement heralding the coming of the omnipotent energy, light and life-giving Mr. Sun. Upon marveling in its glorious arrival, I would be out the door for one of the joys I loved about my old routine, my morning jog. It was usually five miles, no matter the weather. I would swiftly be off down the road, enjoying the sounds of birds awaking to sing their song to others, echoing the arrival of a brand-new day. It was wonderful to jog along with a long stride and steady gait and see my sleepy little rural town awake to the new day. The same lights would already be on in the same houses. A few ladies along my route would be up and out, tending to flower gardens as a part of their morning routines. The same early commuters would be pulling out of their driveways, off to their jobs, and on the road before the rest of the regular commuters and, without fail, the same dogs awaiting my arrival to come nipping at my heels. Small trivial things I would love to have back.

The new me has only one eye with tunnel vision, no bilateral fields of view at all, and the ability to only see an area about the size of a dinner plate at one time. It takes several minutes to take in all my surroundings even though they are very familiar to me. The images are blurry at first until I remember that the new me needs to wear glasses. I fumble around for them anxiously. Upon finding my glasses and putting them on, I begin the scan of my bedroom once again. This time putting each little section of perception together like puzzle pieces inside my head to form larger images of the world that now surrounds me.

I do not have feeling in my left leg but know it is there, which brings a small bit of comfort to me (another little victory). I ache, and I am in pain. I really do not want to move at all knowing the already-intensifying pain will get worse. But move I must if I am to get to the bathroom and take my medicines, which will take the sharp edge off my pain. Not eliminate it, mind you, but make it subside enough that it is bearable and I am able to function. But first I need to tend to my leg. A residual effect of my traumatic brain injury (TBI) is that my brain and my left leg are not always on speaking terms. I must rub and massage the larger muscles in my thigh until I can get some circulation going and some kind of feeling in it so that I might have a chance of standing upright without falling flat on my face. Usually, after a few minutes of doing this, some feeling will come. If it does not, well then, I know that it will be my wheelchair I will need to get to rather than gathering in hand a support cane. This morning brings another small victory as soon my left leg begins to sting a bit when the familiar tingling returns.

Tired of the memories that have also awakened and started racing through my mind in no order, sequence, or any other format that could be labeled as organized, I finally decide I must get out of bed. I sit up and give a moment for the lightheadedness that this small action created to go away and then move my legs to the side of the bed. Again a pause, another check of my surroundings, and upon locating my support cane, I take it in hand. With the aid of the support cane and a lot of effort, mentally and physically, I shove off the bed and on my feet. Yeah! This is another small victory for me. After I have taken a moment and straightened the kinks and bends out of my body, I try to make myself stand erect and succeed.

I am up. My day has now officially started. Now, to take some steps forward, make my way to the bathroom, and see if I can make something out of it. "Good morning," I try to tell myself. Though as of yet, I have found very little pleasure in any of it.

Once in the bathroom, I immediately stop and am somewhat startled. I notice the mirror and the image staring back at me. Good hell, what an unpleasant view to wake up to. The image of the man looks horrible to me. He is—or rather, I am—thirty pounds lighter than the old me and look thin and hollow-cheeked. With a bedhead hairdo, stitches in my forehead from a fall earlier in the week, and only one eyeball—as I have yet to put my prosthetic one in its socket—I feel like Frankenstein. Or rather, like I am an anorexic, a broken and frail version of him. The morning victories get erased as I get slapped with this view of the new me. I can easily count this as my day's first mental defeat.

However, as it is a morning view I have seen for some time now, I am able to simply grunt a sound of hate for this image that I see and can proceed to take care of the morning's first priorities, the new daily routine that has replaced the early morning jogging of my past. The past, being prior to my combat tour of duty at war in Iraq. The past, prior to me being blown up six times while being a bomb hunter looking for improvised explosive devices (IEDs) on city streets and rural county roads all throughout that damned country, as well as getting shot at, ambushed, and attacked.

It does not take much for those memories to flood into my brain-damaged head. It is much harder to shove them out or shut them down so I can keep going rather than let them overcome me and mentally shut down and drown. I manage to put them in a bubble that I pretend to blow away and then wipe away a tear or two and get back to reality: me, this new me, getting ready for a brand-new day.

It used to be as easy as a quick stop at the toilet, then on to a little pick-me-up at the sink as I would wash my hands and face. I would knock what little sleep was left out of my eyes and mind as the warm water splashed upon my face, then on to taming my bedhead with a comb and brushing my teeth, followed by a good blast of mouthwash and a quick change into my jogging clothes. At most it took fifteen minutes.

Good morning, stud, and welcome to the new you. My morning ritual now will take at least an hour if I hurry some and do not get distracted at all.

At this point, relative to receiving my war injuries, I have been traveling down my recovery road now for approximately two years.

When I first returned to from Iraq and ended up at an army medical treatment facility in Fort Carson, Colorado, I was immediately diagnosed with a TBI, severe hearing loss, and loss of vision. I was further diagnosed with neurological damage, post-traumatic stress disorder (PTSD), and damage to my teeth and jaw. They had not seen a lot of TBIs at that time, and a decision was made to transfer me for treatment to the veterans' hospital in Salt Lake City, Utah. There I immediately received treatments to stabilize me medically, and they continued to further find, diagnose, and treat new injuries and wounds. Some of my injuries required referral to medical specialists outside of the veterans' hospital. This occurred immediately when it was required.

In a nutshell, I had, in direct combat with enemy forces and instruments of war, suffered severe brain damage, profound hearing loss, had a broken neck with right-side stenosis (restricted blood flow to the right side of my brain), and was found to be legally blind. I had damaged vertebrae in my lower back (L5 and L6) and had upper respiratory problems (due to the damage done to my throat and upper lungs) from inhaling the intense heat and gasses that engulfed my vehicle as the fireball of the bomb rolled over and through it. I also had a broken jaw and shattered teeth and had tremors, seizures, tics, and abnormal body movements I couldn't control; a nonworking bladder; craniofacial damage; severe pain; and PTSD.

By this time, I had received treatment in six different hospitals in three different states, had three major surgeries, and had been treated by forty-nine different primary health care specialists. I had also lived in an assisted-living facility for some six months.

I had received craniofacial reconstruction; had my left eye anatomically removed in surgery; received a cochlear implant; received extensive mental health treatment; received hyperbaric oxygen chamber treatments; had long-term hospital stays; received extensive physical therapy, speech therapy, occupational therapy, and mental health therapy; and had extensive neurological testing and treatment and medicinal treatment. There was a time when I was taking thirty-six different prescriptions at one time, morning and night. Once I had an accidental overdose and spent some time in hell, rebounding from that in an intensive care unit.

By this time, I had also been treated in an urgent-care facility or hospital emergency room over thirty-five times for severe head injuries from blackouts with falls that required ten or more stitches and often were accompanied with a concussion (that number is now up to fifty-nine). I had broken my nose three different times; nearly cut off an arm; broken two different fingers (on different occasions), which required surgery and pins to put back together; cut a finger completely off, which was saved and reattached (thanks to a very skilled hand surgeon); and been on a straight liquid diet, which consisted of five cans of Ensure every day—one flavor only (vanilla)—for two years (it has now been over four years).

I require a conservator to do my finances as numbers do not mean much to me. My brain just does not comprehend how to do even some basic math, which is frustrating indeed.

I require the use of a continuous pressurized air pressure (CPAP) machine, with an oxygen machine feeding it at night to breathe, as I sometimes quit breathing in my sleep.

I cannot always walk. My legs often do not want to work. In which case I am wheelchair-bound until they and my brain decide they want to communicate with each other.

When I can walk, I require a support cane in one hand, a blind man's cane in the other, and I am supposed to wear a helmet. I admit I do not always wear my helmet, which, yes, I know would have prevented some of the emergency room visits. I have also been hit by vehicles while crossing roads with my canes by people who never see the blind man. Just another part of getting used to my new world and learning the tools and techniques I need to survive in it.

You add it all together and you have the brand-new me!

One thing I did learn after twenty-four years of military service in my occupational specialties was the ability to adapt and overcome in any environment.

That is what I tell myself I must do every single day, adapt and overcome!

Chapter Two

First, I must locate my glasses and my support cane, then go drain my bladder, as most people do right after they wake up. I once stood tall before the toilet, with my manhood proudly in hand and on autopilot, without having to think about it at all. I could stand and piss a stream of urine like a man. It was a simple little task taken for granted then and only took a minute of my time. However, it is quite a different story now because of my TBI. A neurological residual effect of my brain damage is that my brain chose, among other things, to divorce my bladder. They no longer communicate. My bladder does not function on its own. A flaccid neurological bladder is the official term I believe the doctors used. All it means to me is that my bladder no longer works on its own. So what used to take me a single minute now takes five or ten, depending on how I am feeling. I require the use of a catheter to drain my bladder.

Basically, a urinary catheter is a tube that is inserted into the urethra by inserting the tube into the head of the penis on a man or through the small opening just below the clitoris and above the vagina on a woman.

You begin first by thoroughly washing your hands with soap and water. Then you must thoroughly wash around the opening you are going to insert the tubing into. As infection is a fairly high risk when using a catheter, a good cleaning is necessary to prevent getting a urinary tract infection, which, trust me, is not fun at all.

A person needs to use urinary catheters basically for one of two reasons. One, they have a condition called urinary incontinence. This simply means the bladder lacks the ability to hold urine in the bladder. You constantly leak, so to speak. The second reason is for a condition called urinary retention. This means that a person is not able to urinate, not able to drain their bladder on their own when they need to.

Urinary retention is what I suffer from. As a result of my brain injury, the message my brain sends to my bladder to open the valve either never makes it to my bladder or is not interpreted correctly when the message gets there. The result is the valve never opens. Chances are, it will never open again. Therefore, urinary catheterization is something I get to look forward to for the next forty years.

I am not an expert by any means—other than the fact that I am an expert in using a catheter. So keep that in mind as I tell you, in my own layman's terms, these are basic descriptions. I am explaining the differences, as I know them, to help in understanding why I must do what I do to drain my own bladder.

There are basically two different types of urinary catheters. These are either indwelling catheters or intermittent catheters.

Indwelling catheters are called such because they are actually placed within the bladder and remain there for a long time. A long tube with a deflated balloon attached to it is pushed up the urethra and into the bladder. Once there, a small amount of sterile water is pumped into the balloon, which expands and keeps the catheter in place as well as seals the bladder opening so urine cannot leak by it into the urethra and down your legs. Urine then flows through a long tubing system that is either attached to a bag secured to a person's lower leg or a collection bag attached to a wheelchair or attached to the side of a hospital bed. The bag must then be emptied daily and routinely cleaned. These catheters are also referred to as Foley catheters. A person using a Foley catheter is usually paralyzed, hospitalized, or otherwise unable to use and take care of other catheterization procedures on their own.

There are Texas catheters, also called condom catheters. These work the same way as a Foley catheter except that no tubing is pushed into the bladder. Basically, it is like a small condom that fits over the penis with a tube attached to it that drains the urine into a bag. The bag must then be emptied daily and routinely cleaned, just like the bag on the Foley catheter. These catheters are used only for very short periods because of the high risk for urinary tract infections, damage to the penis from the friction of the condom constantly rubbing against it (it cannot be lubricated or it would slip off the penis), and also the risk of urethral blockage because of the compression of a tightly fitted condom on the penis.

Intermittent catheters can usually be inserted by the person using them or with the aid of someone else.

(Continues...)

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Excerpted from A Lifetime at War by Gordon L. Ewell Copyright © 2012 by Gordon L. Ewell. Excerpted by permission of Trafford Publishing. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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