Beautifully Broken

by Paige Wetzel

  I was so proud of Josh and for Josh, but the truth is, I almost missed it by thinking I was there to take notes, ask questions, and hold a wound vac like it was just another day. How disappointing would it have been if Josh had just stood on his own for the first time since his injury and I followed it up with logistical banter? “Yeah, honey, that’s great, but we need to hurry because you’ve got an appointment in thirty minutes.” I was caught off guard by my emotions because so much more had happened than what the eye could see. Not only did Josh rise up out of limitation, but there was a literal transfer of power that I did not expect. Making these prostheses walk was the first thing that I couldn’t do for him. He had learned how to bathe himself, propel his own wheelchair, and make himself a sandwich, but if he ever rendered himself unable to do those things, I was ready to step in and reclaim those tasks. I had finally arrived at the threshold I could never cross. There was nothing I could do to make him stand and take steps with man-made legs. That is the miracle I almost robbed myself of. I was enlightened to my own form of numbing this whole hospital experience: plans, schedules, tasks, and busyness. I don’t have to feel things if I’m busy. But busy had the power to become the distraction we were already battling in our marriage counseling. It created an unspoken rule that suggested I didn’t have time to stop and appreciate or encourage. In so many ways I was liberated that day, too. We received a small glimpse into a life of real independence, a word that I once believed meant that we as a couple were independent from the oversight of the military, nurses, and doctors. Today, with clarity, I saw that independence meant Josh Wetzel could take care of himself. I pledged to work on relinquishing myself from this exhausting, numbing sense of false control and to live in the moments that could never be taken away from me.

  My favorite part about the family rotation was everyone getting their own emotional moment when they saw Josh walking. I loved taking our helpers to physical therapy. I would sit them down in just the right spot so they could see how far Josh could walk. I would watch everyone’s reaction out of the corner of my eye like I was watching a child being surprised with a puppy. Josh’s physical therapy created most of the content we shared online—Josh walking, throwing a football, riding a hand cycle, and so on. The response was amazing. People from all over the world would tell us they started their business meetings with videos of Josh as their “Monday motivation.” Even churches were pausing their sermons to show these videos to their congregation. We lived and planned to spread encouragement every day in physical therapy.

  The hard part was everything our followers didn’t see. At this point, Josh could walk for about five minutes at a time, and then he would have to sit. While seeing him walk every day was miraculous for me, it seemed like every step he took would be one minute of misery later. Josh would be in his legs for about half an hour, then go back to our room needing ice, pain meds, and massages. His legs were unnaturally red and blistered for hours after just a few minutes of walking. Each stride responsible for moving seventeen pounds of steel, plastic, and titanium created rigid soreness in his hips. In the back of my mind, I knew walking would get easier, but would his legs ever feel right? What were they supposed to feel like? Was there just a level of daily pain he would live with from then on? Does anyone ever say that they are comfortable in prostheses? No prior experience is a huge blessing sometimes, but in the back of every amputee’s mind, does “feeling better” just mean it hurts somewhere else?

  Life continued to have its highs and lows. Shortly after receiving his legs, Josh had his skin graft surgery to cover the infected donor site. The donor for the donor site was coming from his hip area. He would have to rest for a few days, which meant no walking. Josh wasn’t loving that, but I was so thankful his back would finally be closed. The day after the surgery, Josh’s hip donor site was really hurting him. His symptoms reminded me of how I felt when I had my appendix removed in sixth grade. I remember feeling like a sneeze would bust my guts open. The next day, Josh’s pain had increased and his hip incision was swollen and hard. After a full day of trying to relieve his pain, the doctors decided to take him back for an emergency surgery around 6:00 p.m. Surprise! Josh had a hematoma the size of a tennis ball behind the incision. It was drained and he was given pain medication to get him through the weekend. Maybe this will be the last surgery, I thought for the hundredth time. I hated that Josh had to have another procedure done, but in hindsight, I think it kept Josh from overdoing it in PT on new prostheses and with a fresh skin graft on his back. Josh had proven he was not able to take things slow, and we could not afford for anything to upset the skin graft or the healing scar on his hip.

  It was essential for Josh to take time to heal slowly but healthily, because our social calendar was starting to fill up. We had gone from our days “socializing” with doctors and nurses and therapists to actual socializing with friends, new and old. Some amazing things happened: Our friends from down the hall, Jenn and Drew, had their first baby. I was there to take pictures and to welcome baby Easton Mullee into the world. Josh and I also finally got to go to a Red Sox game at Fenway Park with his mother, Tori and Andrew Smith, and our occupational therapist, Captain Johnson. They treated us like royalty. Josh walked onto the field on his own, and then we got to eat in the owner’s box during the game. We had steak and lobster and then had dessert brought to us in our seats. We sang “Sweet Caroline” just like any respectable Red Sox fan would and loved every minute of our time in that ballpark. We were finally doing something “normal” and not rushing to the ICU instead. Josh also had his first public fall during the dinner.

  JOSH

  Yawkey Way, the Green Monster, watching David Ortiz take batting practice… This was living the dream! All the walking I had been doing had been amplified when my therapists dangled this carrot in front of me. They said if my walking was proficient enough, they would take my mom, Paige, and me to a Red Sox game (my favorite team) at Fenway Park. The Cathedral. I was able to step onto the red carpet of infield turf and watch the best players in Major League Baseball hit missiles off the giant left field wall. Some of the best players of all times played in this stadium—Ted Williams, Babe Ruth, and Carl Yastrzemski had all become legends here. My fanatic desires had all been met, and I had not even gotten to my seat yet. Turns out this evening would be more legendary than I thought.

  It all started once we were seated for dinner in the fancy stadium suite that sat directly above home plate. The restaurant was one of those white tablecloth places that give you too many utensils. When Andrew announced he was going to the bathroom, I said, “Race you to the handicapped stall” and attempted to run like I actually had legs. My slow-swinging robotic knee caught the toe of my shoe on the floor, and I was suddenly eye to eye with the table leg next to my wife’s purse. The kitchen staff and our gracious hosts all ran over, but Captain Johnson encouraged everyone to give me some space so I could get myself up as he had made me do a dozen times in the MATC. In the swarm of concerned patrons, I waved everyone off and went to work getting my legs under me to stand again. As I squirmed to figure out which way to bend and straighten my legs to stand up, Andrew carefully walked around me to the handicapped stall. When you gotta go, you gotta go. Finally, I was experiencing that weird chaotic feeling of operating robotic appendages during a real fall. These things clanged and clunked against each other as I wallowed on the floor for several minutes. All the caregivers (including my mom and wife) laughed until everyone was in tears. I finally got my feet flat on the floor and decided on the “down dog” position to stand up. Now, I was right behind him. I would love to say that was the only calamity that day, but after a successful venture to the restroom, I found myself again with a lowly view of the restaurant, this time with my cheek against the wood floor because I had caught my foot on the floor divider between the restroom and the dining area. This restaurant was out to get me! This time was worse than the running attempt. Trying to remember the move I did last time, I had almost gott
en on all fours when the door closed on me and knocked me flat. I tried to get my right foot flat, and the door shut on me again. Finally, I had to Army crawl out of the doorway, dragging my tangled heap of metal behind me. A waiter (who missed the fun earlier) rounded the corner and hurried to help me up, but by this time, the whole dinner party had been trained on amputee occupational therapy. As the young waiter leaned down, the whole table yelled, “Noooooo, leave him alone! He can get up by himself!” I did my ever-so-graceful maneuver to stand again (read: awkward as a baby horse walking right after birth), only to see my entire table in stitches. No one could catch their breath and I watched Paige release the tension that outings like this gave her, even if it was laughing at my expense. I’d take it all day long to see her genuine smile and hear her laugh. Only later was I informed that Captain Johnson was nice enough to take pictures—both times.

  I was proving step by step that we could handle trips outside of the hospital. It was actually just as reassuring to hospital staff that I could fall and not hurt myself as well as get myself back up. I was excited about this because there were several adaptive sports trips that we kept hearing about, but we had been told I was not “healthy enough” yet to attend. I made it clear to my new battalion, the Warrior Transition Battalion (WTB) cadre, that PT was the most important part of my day. I was not willing to cancel or skip PT for any other appointments or meetings, because I was determined to find the right set of legs and get better at walking. I was going to play sports again. I was going to shoot hoops and take a trail walk and go swimming and climb stairs and maybe even try skiing. Nothing was going to stop me. All I had to do was get the right fit for my sockets. What a naïve thought that was.

  I assumed the pain and discomfort from my first steps was from muscle weakness and not knowing how to balance on the new ends of my lower half. Boy, was I wrong. My legs were changing and morphing every time I wore the prostheses. What was left of my lower extremities was rigid with aggressive bone spurring that was still growing, a condition called heterotopic ossification. It’s where the body dumps massive amounts of calcium deposits in an effort to heal a traumatic bone loss. Except the bone formation doesn’t make any sense. For me, I felt extreme pain in my right hamstring, which called for X-rays. Seeing myself as a skeleton was already the weirdest thing I had ever seen, but when I looked at my right femur, a huge chunk of bone mass had collected where my hamstring muscle should be. Instead of a long, skinny leg bone, the middle of my femur looked like it swallowed a brick. I knew I had some of this bone growth, but nothing drew my attention to it like trying to make huge plastic sockets fit comfortably over it.

  The shape-shifting bone growth along with the tenderness of my skin and weak muscles made it hard to pinpoint what fixes needed to be made with my sockets. All I knew was that it hurt. This caused me to get recast for new sockets almost twice a week. Each Monday, a prosthetist would wrap my legs in the wet papier-mâché material and take the molds back to make new sockets. By Friday, those sockets hurt so bad that I couldn’t even put them on. Was it because my legs were changing? Was it because I was swollen? Was it because I was sore from yesterday? Were these new sockets too tight? The hardest part was that the people making the prostheses weren’t amputees. None of them could understand how or why it hurt; they just took our word for it and went into the lab and tried again.

  After my third week in a row of really awful pain in my legs, I looked at my physical therapist and asked, “Just be honest with me, is it always going to hurt like this? Am I just going to be in this much pain for the rest of my life? These things don’t ever feel better; they just hurt differently.” He confirmed that many of his patients dealt with weeks of pain before the prostheses felt right, but I did not have to just accept whatever sockets I was given that week. While it was going to be a grind, walking should not feel like torture every day. I needed to get more in tune with my body and figure out what discomforts were helpful in breaking in my stumps and which were unacceptable pain that required adjustments to my sockets. I suddenly understood that all of this was a process. At this stage, it was not about making prostheses fit; it was about toughening my skin, strengthening my muscles, and forming my legs to the shape of a socket, not the socket perfectly forming to my leg.

  Until this realization, my process had been do PT, go home, swell up, try on sockets that were too tight the next day, do PT anyway, get blisters, get sore, squeeze into them the next day, do PT until I cried and the blisters ruptured, throw the prostheses in anger, take the weekend off, and do it again the next week—all while still holding on to the parallel bars, not even independent enough to walk with a cane yet. My amputee friends were all I had. Knowing someone who was just a few weeks ahead of me would confirm that if I just hung in there and communicated better, the sockets would change along with me. All my friends said there would be a lot of adjustments when figuring these things out. Sometimes I got blisters because the knee was too heavy, not because the socket was too tight. Sometimes the pressure on my shin came from my foot being tilted too far forward. Sometimes my sockets were too tight because I had eaten too much salt. When I tried to cut the salt and hydrate more, my legs shrank!

  Getting prostheses was the hard pivot in my recovery. It required my full ownership. Up until this point, the people who took care of me may not have understood my pain, but they knew what to do to help me. There was no cure-all for mastering prostheses, and no one who made prostheses, fixed prostheses, or helped amputees walk in prostheses knew what it felt like. For the first time since I arrived at Walter Reed, my mom and my wife could not speak for me.

  I had to separate the gradual buildup of calluses, aggressive shaping of my muscles, and hardening of my flap from the pinching, rubbing, and pressing. My friendships were crucial, because even though I had a physical therapist and a prosthetist watching me walk, sometimes it took the voice of a fellow amputee saying, “You look like something’s pinching you in the right leg,” for me to say, “That’s it! That’s the problem.”

  CHAPTER TWELVE

  OUTPATIENT

  “At that time I will gather you; at that time I will bring you home. I will give you honor and praise among all the peoples of the earth when I restore your fortunes before your very eyes,” says the LORD.

  —Zephaniah 3:20

  PAIGE

  Despite the sharp learning curve with prostheses, other exciting things were happening: We were finally moving to Building 62… for real! We had a real room assignment and everything. Josh’s recovery from the infection sidelined him from all activities for a week. But we were held up from life at Building 62 because of the wound vac that was still trying to heal his back. Our doctors told us that wound vacs could not go to outpatient for fear of malfunction or damage. Josh was pretty upset about that, but personally, I was grateful. We kept the wound vac for twenty-three days, then immediately requested another shot at outpatient. On September 5, we packed up our inpatient room and high-fived the entire hallway—I’m sure they were ready for us to go, too. Although the move to 62 was exciting, there was another requirement that we didn’t foresee: Josh would be officially assigned to the Warrior Transition Battalion, which means he would not be part of the 1-23 Infantry Battalion A Company Earthpigs any longer. It was time to play Army again. Josh was assigned a cadre that he was accountable to every day. We were required to check in with a squad leader every morning to let them know that Josh was awake. Then we had to physically check in with them at some point during the day, usually to complete tons of paperwork. Josh was told about two months after we arrived at Walter Reed that he was not physically eligible to deploy. I was not surprised to hear this news, but Josh, under the influence of heavy pain medications, was more shocked over this than the Ninja Turtle attack. However, he would be able to medically retire from the military, which meant that we would at least have a paycheck after he got out of the hospital. Although I knew that Josh was disappointed, I was so relieved to learn that we qualifie
d for retirement. Not knowing anything about Army retirement, I assumed Josh would get paid until his contract was up. Then he would just get out of the hospital and claim a disability check, and I would have to go out and make the money. The thought of applying for a job terrified me. How would that conversation even go? “Hello, yeah, so that large gap in my resume is because my husband was injured on a deployment and we were living in a hospital. No, I didn’t finish my master’s. No, I have never had a full-time job because before he was hurt, we had just moved to Washington and I didn’t have a teaching certification for the state of Washington… long story short, I have not adulted yet.” Ugh. I also could not really consider us getting out of Bethesda any time soon. There were people still at Walter Reed who had gotten hurt five years before Josh, because no civilian hospital could meet the needs of their injuries and adaptive equipment. Chances are a nurse in a civilian facility has probably never seen a traumatic amputation. In my mind, we were never going to get too far from an amputee hospital for the rest of our lives.

  At this moment, all I wanted to do was to move into our room in Building 62 and get our private life started. Josh and I had already had a short preview of what life would be like on our own again, and we desperately needed to get to work on figuring out how to deal with the issues we experienced the first time. After filling out a ton of paperwork, we moved into our room. We knew the outpatient chapter of our lives would mean more work but more authority over our lives again, but it was already better than sitting in a hospital room waiting for someone to come tell you what to do. Our marriage was improving through counseling and from being in Building 62 for just a few days. Having our own room meant we didn’t have to throw on the Miss America smile and remember to talk about our “homework” from therapy around constant interruptions. We could go in our space, close the door, and pray the ugly prayers together.