Saying goodbye to Uncle Buddy

Leonard Marvin (Buddy) Kempf was my father’s older brother (Eight years older) and he passed away May 27, 2005, almost 4 years after my father died. He was seventy-nine. He was cremated and he was later interred at Arlington National Cemetery (in the Columbarium) that October. Buddy was the last surviving member of my father’s generation outliving his younger brother and older sister (Doris).

After World War II was over, he went to college on the GI Bill and became a safety engineer. Uncle Buddy had moved away from our hometown in 1955 (before I was born in 1958) and I only knew him and his family from sporadic visits he made to my grandparents in Jeffersonville, Indiana. I remember Buddy as an articulate and well-educated speaker that as a you child I found to be somewhat of a bore. (I was the second youngest of all the grandchildren, only Buddy’s daughter Lydia was younger.) He was a safety engineer and he was a contributor to may safety devices we all take for granted now including motorcycle helmets and seat belts in your car. I admit, even now, safety is a dry subject to talk about.

My uncle served in the Navy during World War II in 1944 & 1945 as a submarine sonar operator aboard the USS Picuda (SS-382) a Balao class diesel-electric submarine in the Pacific theater. The Picuda completed six war patrols during the war and received six battle stars for World War II service. And I only learned of this when I found out that he was to be interred at Arlington in the fall after his death. Since then I was able to read some letters he had written about his experiences during the war and his description of patrolling off the Japan and China coasts.

My last interaction with my uncle was in 2001 when I took him to the airport after my father’s funeral. I do regret that I could have done more to communicate with him and learn more about him while he was alive. I think that is one lesson I have learned as I age, if you want to be with or interact with someone, just do it. You may not get the opportunity later on.

When we learned that Buddy was being interred in Arlington, my brother Richard and I coordinated with our cousins (four of Buddy’s five children), to attend the funeral. It also worked out that my son Kevin and his Wife Stephanie, who lived in Boston could also make the trip to Arlington to pay final respects. Richard and I drove from our homes in Tennessee to Middleton, Virginia where we spent the night and then we met up with the rest of the family at the Arlington welcome center. Arlington lays to rest 27 to 30 veterans each weekday with full military honors. I was impressed, but unsurprised with the efficiency of their process and proud of the level of respect every veteran is afforded there. There are four reception areas in the lower level and they cycle four families and hour, (one family, per room, per hour) through the funeral process all day long. It is a practiced and well-orchestrated process. During this reception and information session, we learned that uncle Buddy was a member of the U.S. Submarine Veterans of World War II. When any WWII submariner is interred in Arlington, they have representatives at the funeral. We met two of these gentlemen, and they were a treasure trove of information on what life was like in these ships during the war. It did cause me to stop and wonder how that will be addressed once there are no members that are able to be there, it was a somber thought.

I’m going to go into a bit of a history lesson here as I believe it is appropriate and it gave me a better background to understand the hardships our submariners endured. These veteran sailors there were telling us about what their life was like on board and it was absolutely fascinating. One topic that is always mentioned is food. These subs had fuel and stores to allow for them to cruise for 8 to 10 weeks without resupply. That came at quite a cost with both food variety and quality though. Fresh foods like salad, vegetables, dairy and fruit were exhausted buy the third or fourth day away from port as their capability to store such items was very limited. This meant that for 7 to 9 weeks, they ate nothing but canned and reconstituted dry goods. I can see where that got old fast knowing my experience with army rations when in a war zone. We had access to additional supplies, they had only what they left port with in the ship.

That brings up another item that I learned, how and where they stored all those canned and dried goods. Space is at a premium on submarines and I never understood how they could possibly store all the food on board. I mean the space was so limited that the sailors had to hot rack. (When you got out of your bunk, someone else got in it to sleep.) no space was wasted. The answer to the storage issue was fairly simple, they stacked all the food stores on the floor. At least one layer on every flat surface and in some areas, like the forward torpedo room, more than one layer. They literally walked on their chow. Spaces not needed immediately, like one of the shower areas in the torpedo room were also filled along with every nook and cranny that could possibly accommodate food was filled and these stores lashed down to secure them. I’ll also take a moment to remind you that this ship was tight quarters to begin with. I was able to tour the USS Pampanito (SS-383) which was the next ship in the Balao class and very similar to the USS Picuda. The ship is a little over 300 feet long and less than 30 feet wide on the exterior and much smaller dimensions inside.

The mess for instance, had seating for about 20 people and was about the size of a small bedroom. The 1st person seated was the last person out as when others sat down, the was no room to move. The galley kitchen was about the size of a bathroom in your house. Zero wasted space. Another consideration was that fresh water was limited, so the showers were infrequent. I can’t imagine that things smelled fresh in these tight quarters. I can see where duty on deck as a spotter was valued just to be outside in fresh air, regardless of how dreadfully boring it had to be just staring at the open sea. Thus, ends the short history lesson.

Back to the reception/assembly area for our family. Our funeral coordinator was very good about keeping us informed on the schedule and how the funeral would proceed. We then went outside and assembled into a small convoy to the memorial site near the Columbarium interment location. It was a sweltering 95 degrees and a beautify cloudless afternoon, not a great day for me to be standing in the sun in a navy-blue suit but I managed. The honor guard was just as perfect in their execution as you would expect at Arlington, and I barely held my emotions in check during the flag fold, Taps and the rifle salute. To this day, Taps is the most mournful song I can think of and brings to me an overwhelming feeling of emotion that I can barely describe. The ceremony concluded with a short walk to the actual columbarium location where Buddy’s ashes were laid to rest.

Later that evening, the family met for a celebration dinner for Buddy at the Fort Myers Officer’s Club, one of Buddy’s favorite places to dine. I was a wonderful time with several stories of Buddy and our remembrances of him.  After the dinner, my brother and I said our goodbyes and headed back to our motel in Middleton and the end of a quite long but incredible day.

Forty (40) days, the countdown continues.

It has been a week since the last post and it has gone well, I am pleased with the progress that I have achieved. I completed my follow up visit with VA Urology and I was cleared by the clinic to have my knee surgery. (There was much rejoicing!) I was pretty confident that the FlowMax was working well, but is was nice to clear that obstacle and continue on with the process of getting this much needed knee replacement. Most days are tolerable, but more often at the end of the day, I cannot wait to get out of the knee brace and try to find some sort of comfortable position.

I have been continuing my preparation at work for my leave of absence. With the last knee replacement, I was on medical leave of absence for 6 weeks and I hope to have about the same recovery period this time. (I may be optimistic, we shall see.) One task I was able to check off was to coordinate with the disability management office for my leave of absence. Last time, this was complicated and a bit convoluted as there are actually two leaves, both taken together. This time, I was relieved to learn that my application for disability will automatically trigger my FMLA and both are now managed by the same case worker. (YAY!) I had called for asking information and was informed I could go ahead and get my leave scheduled and now the paperwork is on its way to me, arriving in two working days or so. It is comforting to know that I will not be losing any pay during this work outage. Between personal days (I have to take five days of personal time or vacation before leave of absence starts.) and the short-term disability, I will draw full pay the full time during my recovery.  One less thing to worry about and one more thing off the list of things to do before surgery.

I’m working off some of my pending tasks at work so I do not have to hand them off to my teammate for him to manage while I am gone. We both cover the same overall area of expertise, but there are several tasks I have been the project lead on or solo worker on, that I wanted to finish up before I walk away from work for a month or two. Last week, I was able to finish one of these and the task was setup as a self-service tool that users can use to submit a request to our logistics team when they need to resolve sending a kit to a customer.

I have been coordinating with my eldest son and his wife to come visit in April during my convalescence and we can celebrate our anniversaries. (My 40th, their 4th?) I think I have a plan worked out and we shall get the details coordinated and plane tickets purchased while the price is still acceptable. (Two round trip tickets for less than $800.00.) The wife and I both think that having some of the kids around will be a good thing to help me keep my spirits up while recovering. Since our anniversaries are less than a week apart, we try to celebrate them together when we can.

Forty-Nine (49) Days and Counting

In forty-nine days, I’m scheduled for my twelfth surgery, a total knee replacement (TKR) of my left knee. I’m looking forward to this with both great anticipation and with the usual anxiety about having any surgery. Let’s face it, I’m six decades old now and I’m not recovering from things the way I used to bounce back. Mostly though, I just want to get the surgery over and get on with my life.

Overall, my wife and I are in a pretty good place in life. I have a great job and I’ve been promoted twice since arriving in Texas in July 2016. We are not fond of Texas in general but the town of Taylor is a nice place to live and that makes it bearable. Unfortunately, about the time we arrived here was about the same time that my left knee started to become very problematic.

My initial left knee injury was pretty ironic as I tore the medial meniscus in it two weeks prior to having my partial knee replacement in my right knee. I succumbed to the most common way of injuring you knee, a flat-footed pivot, for me, it was getting into my car. (Sigh) That was nine years ago and between that injury and a couple other injuries (ACL and MCL tears) time and arthritis, the left knee is pretty well shot. I wear a brace daily and a lot of my activities are affected and or limited by what the knee can tolerate. The dual frustrations of the pain and limitations have been my motivation to get something done about it.

I decided to consult the Veterans Administration (VA) orthopedics clinic in December of 2016 where is was agreed upon immediately that I would benefit from having the surgery. There was only one problem, my weight. While getting the surgery is a bonus for my pain and discomfort, the VA Ortho clinic has guidelines they follow for elective TKR and the one I wasn’t meeting was my Body Mass Index (BMI) of below 35%. This became my first intermediate goal on some life change. The clinic staff let me know that I could get cortisone injections every four months as long as they were helpful and they also gave me a different knee brace to wear while exercising. I weighed about 300 lbs. at the time and I have spent the past two years working on my eating habits and developing an exercise program to slowly lose the excess weight I have gained in the past two decades. I left the Army weighing about 230 lbs., and I would like to get back to under 220 as a long-term goal.

In October 2018, I made my first intermediate goal getting and staying below 272 lbs., (35% BMI). This allowed me to schedule surgery for March 25, 2019 and begin pre-operative screening that the clinic also requires. On the surface, some of the screening seems odd until you look at the demographic of the average veteran that the VA sees for this type of surgery. As a group, we are not in the best of shape and many of us have limits on our routine medical care. VA medical care is needs based and is also dependent on your VA disability rating. It is a complicated process, but let’s just say some treatment is harder to get than others.

The pre-op screening process has included a VA dental exam. (Most veterans do not have routine dental care or dental insurance.) Periodontal disease is not unusual but is averse to any knee implant surgery as the exposing of the bone marrow is an avenue for infection and periodontal disease is one of the easiest routes for infection in the bloodstream. I passed with flying colors due to regular dental care and good insurance. I was interviewed at the Physical Therapy clinic to ensure that I was aware of what I was getting into and they confirmed that I was clear on the post-surgery therapy requirements. I had to show proficiency with a walker, we discussed the issue of stairs (I pointed out that we bought a garden entry home that is a ranch with no steps other than the two-inch step up through the doorway.) and that my wife was already making arrangements with the furniture to accommodate a walker,) The third of these initial screenings is the one that I had a small glitch on, Urology.

You get accustomed to seemingly weird instructions when you visit a new clinic, usually because no one bothers to give you the background on why you get the instruction. But, as a good soldier, I just follow instructions and I generally will learn as the need to know is determined. In this case, Urology said arrive at the appointment with a full bladder. Those familiar with the military medical system know the unofficial motto: “Hurry up, and wait.” Arriving at a new clinic was a concern, but I was glad to see I was called back just a few minutes after my appointment time. The technician was friendly and inquired if I had the requested full bladder. I replied that I did and was directed to go into this room and pee in the white bucket, then meet me in this room across the hall. The white bucket turned out to be a nifty little device that not only measured your urine output, but also the rate of flow and the duration.

After much relief, I went across the hall for the usual vital signs check then we went across the hall again for another test, an ultrasound. She just said to “butterfly my pants” and lay down on the table. The ultrasound determined I had 150 milliliters (ML) of urine left in my bladder (surprising her as I had peed 305 ML.) and I was told to zip up and go back to the waiting room until the doctor called me back. This too wasn’t unexpected.

About the time I was getting ready for the clinic visit, I’d come to the realization that I’d been putting off going to the doctor about my “old man pee” situation because it hadn’t become a severe problem. I’d say very slowly over the past decade I had noticed that I was having minor issues with having to go more often and sometimes very urgently only to have a hard time starting, but I’d never seriously thought about talking to someone about it. After what I had just experienced, I concluded that I likely had an enlarged prostate, which was quickly confirmed when I was called by the Urology Physician’s Assistant (PA). We had a very detailed discussion and I learned they had a very complete screening protocol that resulted in us spending about twenty minutes in a question and answer period about my urinary habits. Then it was across the hall to an exam room for the standard drop your trousers, external exam and digital rectal exam to check for prostatitis and enlargement. No prostate infection (I’d had one over 20 years ago, not fun) but further confirmation of the enlarged prostate. This is apparently present in better than fifty percent of senior males.

I was sent home with a provisional diagnosis of an enlarged prostate, a prescription for FlowMax to see if we could increase my urine flow, a follow-up appointment (next week) and a better understanding of why this was important to a knee replacement patient. During the surgery, you are catheterized and it is normally left in place a day or so post-surgery. The PA explained that with a swollen prostate, the concern is when the catheter is removed, the urethra may swell shut making urination impossible. Therefore, pre-operative treatment is recommended to ensure this issue does not occur. Lord only knows I so not need to make the recovery process any harder than it already will be, so I am glad they have developed these protocols. For what it is worth, FlowMax works for me. It is hard to tell how much you accommodate an issue until you have it treated and see positive results in a couple weeks. Trips to go pee, easily cut in half. Urgency issues almost completed abated. Side effects of the medication so far minimal and easily addressed. (Dizziness on standing is the most notable due to reduction of blood pressure.) The medication works well enough that I recommended it to others.

After my follow-up with Urology where I expect to be given a green light for surgery, then the next hurdle is the 7-appointment day a week and a half prior to surgery. These include:

• Chest X-Ray
• Labs
• Electrocardiograph (EKG)
• Anesthesiology
• Ortho Clinic
• Ortho Ward 

Appointments start at 8 A.M. and go through 2 P.M., it should be a fun filled day with lots of time sitting in waiting rooms and maybe two hours of actual productive time getting a test or briefing from someone.

One other fun facet of this, is that it is possible that the timeline for surgery could move up. If someone on the list ahead of me cancels due to health issues or such, they move people up who can accommodate the change in schedule. I volunteered, but as yet, nothing has changed for the original plan. I still have to coordinate both Family and Medical Leave Act (FMLA) to maintain my job while off work and Short-Term Disability (STD) to continue to get paid while off from work in recovery. You would think these would have one combined case worker, no such luck. I learned this with my last knee replacement and I am prepared for the bureaucratic nightmare that taking medical leave can be.

This winter has made playing disc golf (one of my main exercise activities) difficult due to the number of rain days where it is either raining or the courses locally are too wet to play. I’m hoping for some dry weather soon, but the ten-day forecast is not promising. We appear to be finished with cold weather for the most part and I expect we will do the standard Texas skip spring and jump directly to summer and 100-degree heat while I am convalescing.

I have been remiss in my regular writing in the past few months due to laziness and some lack of inspiration. While I am not especially inspired at the moment, I am trying to beat back the specter of laziness and get some of these thoughts (however random) jotted down before I forget again.
Other minor achievements since my last missive have included changes at work (a second promotion since moving to Texas) my job being transferred from one division to another and a new manager as a result. I retired the 2007 Pontiac G6, took my wife’s 2011 Hyundai Elantra and bought her a 2018 Hyundai Sonata Hybrid. There have been some trips to New York (wife went solo last April, we went together in September for my birthday.) and all the kids, daughters-in-law, girlfriend and granddaughter visited the first week of January for a late Christmas. I can truly say I was busy in January 2019 and too busy to write during their visit. No real excuse for no other posts though, just lazy.

I think I’ll wrap this up for now and see what thoughts I can get written down in the next week or so.