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Change In Care


PN Staff
Reprinted from PN/Paraplegia News August 2016

Four decades ago, spinal-cord injured veterans dealt with troubling care practices at the Bronx VA Hospital. Now, their standard of living has improved.

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Although Andrew Kmetz has spent most of the last year-and-a-half bedridden with his first wound, it’s nothing compared to what the 69-year-old Army veteran went through during his first years of paralysis.

A quadriplegic, Kmetz shared a tiny corner of a room with trash cans at the Bronx (New York) Department of Veterans Affairs (VA) Hospital in 1970. Human waste stuck to the floors. Dirty linens piled up around his bed. The roof leaked. Rats raced around. 

Care was hard to come by. He spent two-and-a-half years there. Life was rough. 

Now, despite all the ups and downs, he’s thankful for the improvements in care for paralyzed veterans in the United States.

“Life’s been a dream,” Kmetz says. “It’s been tough, but that’s the way it is. It’s a lot better than what it was then, that picture, that’s for damn sure.”

Slowly Getting Better

Forty years ago, paralyzed veterans’ care was extremely troubling.

A May 1970 Life magazine article depicted it and earlier this year, Paralyzed Veterans of America (PVA) President Al Kovach Jr., displayed that issue during his testimony before a joint hearing of the House and Senate Committee on Veterans’ Affairs, reminding members how bad it was and how much it needs to improve. 

That Life article painted a depressing picture for those with spinal-cord injuries and how they received hospital care. Facilities were overcrowded and understaffed. Conditions were deplorable, especially at the Bronx VA.

According to the article, patients were sometimes left unattended for hours and could wait up to four hours at a time before an aide took care of them, while nurses could handle as many as 80 patients at one time. Patients couldn’t get a glass of water for themselves. Urine bags spilled out onto the floor and the smell never left. 


Paralyzed Veterans of America staff check out a resident room at the Spinal Cord Injury Long-Term Care Unit in Long Beach, Calif. Photo Marc Hubbard, VA Long Beach Healthcare System..

Socially, it was tough for paralyzed veterans to fit in, too.

Peter Lassen served as PVA’s Executive Director from 1968 to 1970. Lassen was injured during a mine explosion on Oct. 21, 1954, in the Vietnam War. After his injury, he was transferred to Womack Army Medical Center in Fort Bragg, N.C. He spent a year there and said there were lots of World War II and Korean War veterans who were basically living at the VA hospital. 

“What that means is that there wasn’t a lot of attention paid to get people back out into society, get them mingling, get them doing stuff, get them occupied, get them employed, all of that. It was more keep them here in the hospital because presumably that’s all there was for them,” says Lassen, who later became an architect and is now semi-retired and living in Los Angeles. “The VA, at least when I came through, which was Long Beach, had lots of people coming in for bowel and bladder care, particularly bowel care. So they [paralyzed veterans] would come into the hospital regularly to do their bowel care and not be focusing on their independence. There’s no question that many were independent … But what I think is it took some of these guys saying, ‘No, dammit! I am not going to live at the hospital. I am getting out and making a life for myself.’”

Painful Memories

Four men — Marine Corps veterans Marke Dumpert, Parcel Wheeler and Frank Stoppiello and Army veteran Kmetz  — were featured in that Life magazine article, shown in pictures and quoted about their treatment and care at the Bronx VA. 

Dumpert and Stoppiello have since died, while multiple attempts to contact Wheeler failed. 

Then, there’s Kmetz.

As he turns 70 next month, the Copenhagen, N.Y., resident has survived, as he calls it. Kmetz has lived in Copenhagen since the early 1980s when he had his house built there and has spent the last 47 years as a quadriplegic. 

He doesn’t go near the Bronx VA because it brings back too many painful memories. 

He’s dealt with a few major health issues over the past couple of years, including kidney stones and surgery for a triple aortic artery aneurysm, and had a few major hospital visits. Admittedly, he doesn’t go to any hospital much anymore. Instead, an occupational therapist comes to his house. 

For 20-plus years, Kmetz’s wife, Edith, took care of him. She developed breast cancer in 1990, then he got an aide for both of them in 2001 through the Northport VA Medical Center in Northport, N.Y. After his wife’s death in 2006, Kmetz hired another caretaker for bladder care. Now, he has nurses come to his house three days a week to help him. 

“Aides care. You don’t have to pay for water. You don’t have to pay anybody to give you a meal. They don’t eat my food. It’s a totally different atmosphere. I don’t care if they’re black or white. I’m not prejudiced. Up in the Bronx, it was no fun,” Kmetz says. “My wife cared a lot more. But they do their best. But I can’t really complain. I’m happy with it. It’s made my life a lot easier. It makes your mind at ease knowing there’s somebody to come take care of you, turn you, do what has to be done. That’s why I started at-home-based personal care.”

Bowel Care Improvements

Technological and bowel care industry improvements have helped, too. For decades, bowel care could take all day. Kmetz would be up at 6 a.m. but wouldn’t be able to get out of his hospital room until 11 a.m. Then, it’d take another five to six hours of sitting on the commode chair, and he wouldn’t be done until four or five in the afternoon.

“My rear end was numb by the time I got out,” Kmetz says. “It’d be an all-day affair. I couldn’t even go to therapy if I wanted to get dressed.”

Then, in 2010, Kmetz found out about a liquid suppository called Enemeez through his friend and fellow veteran Matthew Rable. Their conversation spurred Kmetz to buy it online. Now, Kmetz takes about an ounce and a half of Enemeez, which contains a dose of 283 milligrams of docusate sodium, and other suppositories, and he only has to sit on a commode chair for an hour instead of sitting in a bathroom for half the day.

“I’ve seen an improvement in bowel care with that,” Kmetz says. “It’s really helped a lot.”

Additionally, he’s learned about and started using Comfort Bath washcloths, which you can stick in the microwave so you don’t have to take a bed bath. They’re filled with aloe and soap, and it makes life easier for his caretaker. 

Back when Lassen was first injured, he remembers being squeezed with 40 to 50 others in a room, being put on a chair or a gurney with a soft toilet seat in it, then being wheeled over to a hopper. 

“It was basically a toilet. And then everybody sits in the same room watching you take a crap, yeah, that’s not great,” Lassen says. “It just wasn’t dignified. That was the case at the Long Beach VA. It strikes me there again that we’ve come a long way. At the VA Long Beach now when I’ve been hospitalized, there’s like four to six per room. It’s cleaner. The air handling is better and all of that.”

Taking Care of Yourself

PVA member Bobby Muller helped get the Life magazine crew in to see the Bronx VA. He can’t stand thinking about those horrid conditions and, like Kmetz, doesn’t go near that VA to this day.

A Marine Corps veteran, Muller lives in Washington, D.C., and now and only sees the doctor when he must. He usually goes just once a year for normal routine maintenance. His only health issues have been torn rotator cuffs and urinary tract infections. Preventative care is important. Muller has developed healthy habits and thinks they’ve played an important role. 

“I think I’m lucky, and I try a little bit to take care of myself. But you know, it’s a roll of the dice,” says Muller, who was paralyzed in April 1969, after he was shot in the chest during an assault in Vietnam. “I move around, get some exercise, have a good diet, no refined carbs. It’s kind of balanced. I cut back on the sugar and eat as much vegetables and fruits as I can, lean cuts of meat, stuff like that and avoiding the problems of drugs and alcohol, which take down a lot of people.”

Lassen follows one simple philosophy — he’s not going to let his spinal-cord injury rule his life.

“It’s a conscious decision I made a long time ago. Yes, I have to acquiesce to it a lot of the time, but it’s not going to rule it. I’m going to do things as I damn well please,” he says. “There are World War II guys and Korean War vets still living in a hospital and occupying a bed. They’re living in bed, just being there. What kind of life is that?”  

 

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