Finally Going Home – Sharon’s Surprise

The last few weeks found me getting stronger, for hopefully, the trip home on May 4th. I was getting used to walking with the prosthesis and walker. Of course learning to maneuver stairs as our condo had three flights of stairs. A hard thing was learning how to get up from the floor if I should fall. Rehab assistants helped me get to the floor then I was to try to get up. Not easy and could not do it without assistance. They said this was normal. They were trying to impress on me that I needed to be very cautious in what I do. I should plan in my mind how to complete each task. I can honestly say that in the last 13 years since surgery I have only fallen once. That was moving from one stair climber to the other. ( A major blessing from Heaven)

Repairs were being made at home so I could move around. The master bedroom bathroom had the tub removed and a shower put in along with a hand-capped stool to sit on while showering. They installed a guard to hold onto while maneuvering to sit on the camode. The main floor bathroom had a higher camode placed in it plus the guard to hold on to. A hospital bed was also put on the main floor which was the living room, kitchen, dining areas and bathroom. this is where I would live pretty much for quite some time.

The biggest item needed was the Stair Climber (Glider) to get from the garage (20 steps) to the living area which had not been found. However, Sharon’s surprise was that monies collected by the Airline Industry friends had totaled $ 1,500.00 for help in purchasing a stair climber. I was so shocked and grateful for such truly wonderful friends and family who also contributed some of those funds. God is so Great!!!

The target date May 4th came and went, but by May 5th, I was released from the hospital. What a superb feeling, but I was also terrified at how I was going to be able to function in a three story Condo. Two Rehab nurses accompanied us home and assisted in helping me to climb the twenty steps to the living room. What a challenge! It took a while, but we made it with no mishaps. Tony holding me on one side and a rehab assistant behind and one in front of me. What a heart warming feeling to be in my home again.

So after instructions from rehab, one of which was to immediately call to get a life line alert installed in our home, in case I fell and was home alone. We called for one that day and I recommended this to anyone with health issues or living alone. Praise the Lord, I have not had to use the life line assistance, but it does give one peace of mind that assistance is just a push of a button away.

So began my life as an amputee/wheel chair individual on my own. Like I said a terrifying feeling, but so happy to be home. Afraid to make a move from my recliner for fear I would fall, but each time walking with the walker to the bathroom, kitchen, recliner got easier. I was getting stronger every day and got into my daily routine.

It was probably home a week or more before Tony attempted to get me up to the master bathroom for a shower. There were two sets of eight steps with a landing to rest for a bit. I would get tired after just a few steps so this took a while. “Man Oh Man” did that first shower feel great. There were times when maneuvering stairs that I would sit on the steps and slide down one by one. Just picturing this would be quite a comical “U – Tube” feature. (Believe me not comical) Things settled more into a routine, but managing the stairs was always the big challenge.

By the end of May, Sharon had found a stair climber for stairs from the garage to the living room. Stair climbers are not cheap, but we found a used one and had it installed. Wow! what a difference that made. Going to doctor appointments, even able to start attending church by June. My blessings continued. I was doing well mentally, physically and enjoying life.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Sharon’s Surprise & My Continued Rehab

Sometime the middle of April – Sharon contacted fellow employees at Penair and many friends
at Anchorage International Airport. She said she needed help in finding a way to help Stair GliderTony and I purchase a Stair Glider (also called Stair Lift) for our three story condo. I knew nothing of this in the beginning. I had been overwhelmed by all the calls, cards, gifts and prayers from all of them. I did not feel they needed to do more, but boy did they. Several long time friends at Alaska Airlines, ERA Aviation and Penair, put together fund raisers, silent auctions, and lunch specials at the airport. So many people worked so hard. The end result was over $1400, enough to purchase a Stair Glider for the 1st set of 20 stairs. What a blessing for us. I was totally amazed and so proud of all of them and the blessing they gave us.

As terrible as January, February and March were, April was buzzing by, lots of hard work, but so rewarding. Tony and I were even able to attend Palm Sunday and Easter services in the hospital chapel. It was wonderful. Day to day routine was getting easier – practice makes perfect.

The rehab trainers met with Sharon at our home to see how I would be able to cope with a three story condo. The stair gliders were a must and as Sharon did her investigation, found them very pricey. The trainers decided I would be making my part of our home the living room/kitchen area which did have a half bath on that floor. I needed a hospital bed for sleeping, bathroom stool would need a guard for holding onto for sitting down and being able to rise.

So, I continued workouts, building body muscles back and learning how to roll a wheelchair by my self. (You would think that should be easy.) There is a certain knack to it and definitely good muscles are needed, which I did not have at first.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Fitting The Prosthesis

Second week of April 2004, my orthopedic doctor, Dr. Chung, advised me I that my left foot stump was healed and ready for prosthesis fitting. He was sending Trevor Munger to do the fitting.

That afternoon, I met another miracle person. He would be a big influence on my healing, mentally and physically and, as far as I am concerned, a friend for a lifetime. This young man (early thirties at the time) with the biggest smile, a bucket and paraphernalia in one hand (left) as his right hand/arm was amputated below the right shoulder. I probably thought, “How is he going to accomplish fitting me for a foot prosthesis.”

Trevor said, “Hello! Are you ready to start the next phase of recovery. ” Still smiling. I said, “Yes, I think so.” I was still hesitant in believing he could do this. He said, “Before we get started let me tell you my story.”

Trevor was born with the right arm not being developed. He became a very active young man. His family encouraged him in all aspects of his life. His disability did not stop him from doing anything and everything he wanted to accomplish. In high school in Kenai, Alaska he became a trophy winning football player and continued on to college to learn the art of making prosthesis. He is now the leading prosthesis maker in Alaska (That’s my opinion, but from what I have read and am told, it’s true.)

I was in awe of this young man. I figured YES. I can do this with God’s grace and help. Trevor explained that first he had to make a cast of my left leg/stump, then design a prosthesis. It would take several fittings before the final product was ready for me to use. That it would take adjustments at different times, as I became used to walking with a prosthesis.

I was in my wheelchair and Trevor sat on floor. Very handily he began the process of building the cast using both arms expertly. At the same time building my confidence of him and his ability to do his job.

I think it took about a week and one day before in he walked with the prosthesis and said let’s put this to good work. I wheeled myself into the exercise room that had the bars to hold onto as I had learned to stand and eventually walk there. What a strange wonderful and scary sensation, putting on the prosthesis and standing on both feet for maybe 10 seconds before setting down.

Trevor told me, “You gotta go easy. Make sure there are no breakdowns in skin, that no sores or blisters start because of rubbing from ill fitting prosthesis.” I was on cloud nine and very happy, but lots of work yet to build up the stump and rest of my body. By the end of second week in therapy I was getting very proficient at dressing myself, using the slide board to transfer from bed ,wheelchair and exercise mat. So onto bigger and better things, learning how to shower, do kitchen jobs and getting into the car (They had an actual small car in the rehab area.) using the slide board. I was feeling pretty smart by then and knowing the lord was with me every step of the way. I was continually praying for guidance and giving him all the praise and glory for my accomplishments.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Recovery Really Begins

My second bout with pneumonia finally ending, and the miraculous recovery of kidney function, I knew I was well on way back to life. Praise Our Father and son, Lord Jesus. I was given the choice of staying at Providence Hospital, or Providence Health (assisted living) for rehab. The hospital supervisor (for rehab) was very straight forward (stern) about the fact they only had a few beds for rehab. People using this facility had to be ready for 8 hours of therapy. This scared me, somewhat, but I was determined to do what ever it took to get well and go home.

They said they would give me a week to see how I was doing. So I was moved to the fourth floor rehab area the next day. The work started. First thing I had to accomplish was just getting up and to set on edge of bed without getting dizzy, or falling over. I did this repeatedly for 2 days. I was managing to set up unassisted for 15 minutes.

Next was getting up early AM to brush my teeth and do a sponge bath on my own. I had to learn how to dress sitting on the edge of bed, eat breakfast. Rest for an hour, then start using a slide board to slide from bed to wheelchair and then back to bed (I had not been fitted for the prosthesis). This was usually a 30 minute work out, then rest and have lunch. Then back to slide board practice. By the end of the week I was able to do morning toiletries – dress and use the slide board to wheelchair with minimal assistance. So, after the supervisor of rehab tested me, she was pleased at how remarkably I was doing . YES, BY THE GRACE OF GOD AND MANY PRAYERS, I DID IT.

The next week was the same routine and they added being taken to the workout equipment. They had me using the hand bicycle machine to exercise arms /shoulders and chest area. I was now using the slide board to the workout mat laying down and working several exercises to build up leg muscles. I did all this repeatedly for a week. It was amazing how quickly all body parts were responding and getting stronger.

My serenity prayers were continual, giving thanks to the Lord and to keep getting better. By the end of this 2 weeks I was operating on my own the manual wheelchair, moving from bed to wheelchair and back with the slide board. I was also moving to the workout mat with the slide board with ease.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Rest Of The Story-Rehab Continues

Because of kidney failure, being in ICU, my muscles, and the ability to even set up in bed was not easy. I was placed in the wheelchair with a lift. When I would try to set up, I would get so dizzy. I would almost faint, or get sick to my stomach. So I had to use a “Hoyer Lift”. They lifted me out of the wheelchair to get my weight each time before dialysis. And also, how I was placed in the chair for dialysis. It was neither a pretty picture nor self-esteem builder, but a day to day task.

Rehab at the assisted living place was slow. They took me to a king-sized bed to practice sitting up. Quite a few days was just repeatedly stretching, sitting up from a laying position and to remain sitting up for 5 minutes at a time. It took awhile. Eventually, I got to 15 minutes at a time. Then I progressed to learn to use a “Slide Board”. It was used for moving from a sitting position on the bed, to wheelchair and back to bed. (had not been fitted for prosthesis yet).

First part of March, my breathing/oxygen levels were not good. So, I was on oxygen quite a bit. I did breathing exercises each day also. That was pretty much the extent of rehab that month in between going to dialysis 3 days a week for 4 hours each trip, which were very cold and bumpy. The last 10 days of March was my getting sicker every day again. Low and behold pneumonia struck again and back to Providence Hospital for care.

It was a very rough 10 days, but the GREATEST WAS PRAYER ANSWERED IN THAT TIME – MY KIDNEYS CAME BACK – WHAT A GLORIOUS DAY THAT WAS AND MANY TEARS AND PRAYERS OF THANKS TO THE LORD!! Believe me I fought hard every day to get stronger and continued “The Serenity Prayer continually”.

During this month of March, I also had my most embarrassing moment- hilarious (in a way). Probably bout the 10th of March, a male nurse shows up early in the morning and says “Good morning Bonnie – I have been assigned to give you your first shower (all this time 3 months were bed type baths), but if you would prefer a female nurse just let me know.” I thought about it a moment and started laughing. And I said, “You are a professional person. Part of your job is bathing males/females and at this point everyone/everybody in this place has seen me from one end to the other and giving me a shower isn’t going to change how I look. So, lets get it done.” There you have it -my most embarrassing/hilarious moment. The nurse laughed to and we got it completed.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Assisted Living/Rehabilitation

After spending five days in ICU, and finding that I had Renal Failure (kidney’s had failed). I was placed on dialysis, possibly for the rest of my life. My mental attitude was not great. I was placed at Providence assisted living/Rehab facility. This facility was about 25 years old. The rooms held two persons and not very much room and not very private either. I was not wanting to socialize with other patients. Most were elderly with terminal aliments. I just knew this was to be my life for the rest of my days. Yes, I was very depressed.

My renal (kidney ) Doc., Dr. Gittimer was very positive my kidneys would return to function normally. This became my continual prayer to God minute by minute.  Rehab was slow, as I had all my muscles to build up after such a long time of laying in bed. But slowly through the month of March, I got stronger muscular wise.  The trips to dialysis were awful. It was cold, snowy and dark.  The Renal center had approximately 30 dialysis machines that were busy from 6am to 11pm. Children, teenagers and adults used the facility. It is amazing to know this machine is such a life giver, but the process to me is plain scary. I saw horrible things from some dying to a persons blood flying to the ceiling. The personnel are so well trained, and very consoling and patient. Some people are on the machines for three hours, others four, I was on the machine for 4 hours. The chairs you sit in are very comfortable, vinyl covered, recliner type. You can bring blankets, lunch or snacks. Each chair has a small TV to watch.

This routine was going along through March, my 63rd birthday was March 28th. Tony and Sharon were planning a surprise birthday party for me. Well, I surprised everybody. I had not been feeling real great, so, about the 23rd of March things went down hill again. I was rushed back to the hospital with pneumonia on the 26th of March – no party for me

Back to antibiotics, oxygen and not remembering much. Tony complained to the nurses that I was always so lethargic and they told him I was asking for pain medication continually. He asked who authorized the pain medication that often. Their reply was at the patients request. Tony got very upset and asked how I was able to decide this, when I didn’t even know who I was. After a big meeting with doctors and staff, I was not given any medication that Tony, or Sharon were not aware of. While fighting pneumonia, a marvelous God thing happened to me. My kidneys started to function, UNBELIEVABLE, I KNEW DOC GITTIMER WAS SURE THEY WOULD FUNCTION AGAIN,  BUT I DON’T THINK I DID.

Amazing recovery! which I made in a few short days, and within a week I was moved to the main floor of rehab in the main hospital. Rehab started with a vengeance to get me out of that place and ready to prepare for life at home. Prayers of Thanks to God, our father, for his blessings upon me. I could see home in my future now.

Bonnie’s continuing story
This post was written by Bonnie Ribitzki a Charct amputee and friend from Gering Nebraska

Brought to you by Charcot Awareness Education Foundation

Facing Charcot Amputation

Look around you when out in public. I find there are more amputees out and about, or maybe I am more aware of this population after I was told I would be one if I didn’t have the surgery. I am so impressed with those I have met that choose to lead very normal lives, even those that are wheel chair bound.

While heading to the grocery store from the parking lot, a tall slender man walked quickly past me. When I looked down I was surprised to see he was a double amputee. You would not have known if he hadn’t had shorts on. While at the acupuncturist with my husband, a young girl in her 20’s literally came running down the long stairs. She, too, was a amputee. I stopped her to find out what had happened. She told me she was in a shipyard accident and her leg was crushed and couldn’t be saved. She was very positive and was planning on running in a marathon this summer. I have seen children who probably adapt better than any of us.

To me attitude is everything. Bonnie is one of those people. She is positive, a role model for others and is busy in her community. Sure she could have stayed home and felt sorry for herself, but she didn’t. That’s why I want you to hear her story. If you are following her story, you know she has had more that her fair share of set backs during this discovery of Charcot, amputation and hospital stay. She was merely told if they couldn’t save the foot they would amputate during surgery.

I wondered how I would take the news. I know my surgeon told me he would make sure his patient understood the consequences and expectations. In doing research on amputation, I often find researchers say that if a part of our body is lost, amputated, we experience the grieving process much like death. Dr. Elizabeth Kubler-Ross in her book on Death and Dying outlines five stages of the grieving process. Omal Bani Saberi, LCSW, CCHT has put these in context of limb loss as follows.

1. Denial and Isolation. “This is impossible. It’s not really happening! I feel nothing at all.”
2. Anger. ‘Why is this happening to me? I’m enraged! God is unjust.”
3. Bargaining. “If I promise to do such and such, maybe I’ll get my old life back.”
4. Depression. “I feel hopeless. Everything is beyond my control. Why bother trying? I give up.”
5. Acceptance. “I don’t like it, but the amputation is a reality. I’ll find ways to make the best of it and go on.”

Many factors including those prior to the event. How well do, or did you handle problems? Your support group of family, or friends, cultural values and norms and of course socioeconomic factors.

Bonnie had so many things going on, I think she went quickly to step 5. I am sure she spent only a short time on the other four. I know though she now talks about being depressed, but I think she has put most of that behind her and spends most of her time being very positive. Her beloved pug, Tuck ja tyo be put down this past fall and that was really difficult for her. Bit she has a new Shih Tzu puppy named Kippur that is taking up much of her time now.

Remember there are 225 amputations of diabetic feet or legs each day in the USA.

Bonnie’s continuing story
This post was written by Bonnie Ribitzki a Charct amputee and friend from Gering Nebraska

Brought to you by Charcot Awareness Education Foundation

Kidney Dialysis and Pneumonia

January 2004, the diabetic doctor told me that Charcot was rare and not mentioned much in medical school. That’s why it was missed. The type of surgery performed was just taking the foot to the ankle as it was not infected. This was, sort of, a rare surgery for Charcot, but new procedure. The physician said I was a good candidate.

Though the surgery was a success and was healing well, I developed what was determined as gout. I was allergic to the prescribed med. Vioxx. This was like 4-5 days after surgery. Within 24 hours I started swelling up.

I wound up in ICU. After many tests it was determined my kidneys had failed. I was placed on continual dialysis for 5 days. After the five days, they had removed 100 Lbs. of fluid. I was still taking an antibiotic drip for eight hours, every 3 days to fight the MRSA. I was then transported by ambulance to their health care unit. My kidneys did not operate for eight weeks. So, I was placed on dialysis 3 times a week, 4 hours each session. Normally, it is a three hour session. They transported me to the Dialysis Facility (which had many, many machines) every Monday, Wednesday and Friday evening. The session began about 7 PM and it was normally midnight before getting back to the care center. This lasted, just, over four weeks.

During this process, I developed pneumonia. So in March, I was taken back to the hospital as this was my second bout with pneumonia. I was on oxygen for a few days each time and had to use the little breathing apparatus to clear my lungs and expand them. The surgeon had to place a port in my left side about three inches down from my shoulder so all meds were given to me went through it. They were constantly giving me something. After kidney failure another port was placed on the left side just to the right of the left breast so I could be hooked up to dialysis machine. I just about forgot, during the first bout with pneumonia, I was not eating, or would not eat and a tube was inserted through my nose to my stomach for the propose of feeding. I had that in from first part of February 2004 until end of February when I was moved to Providence Health care (Rehab and Senior Living housing)

Before Vioxx shut down my kidneys, I had been given an antidepressant. The doctor and nurses kept asking me questions after surgery. I thought I was doing OK, but they determined from my answers to their questions, and the fact that I was not eating, I was depressed. Again I really don’t remember much about the hospital and the pneumonia bouts. I really feel my poor body had been given so many drugs it revolted and said enough already.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation

Listen To The Story Your Feet Are Telling

I first learned I hadCharcot Foot, I had toP5260022 copy work at getting my feet healthy. I had calluses, but no open wounds, though I did have a sore toe which we learned was infected. I was instructed to get my feet healthy. Keep them clean, dry and soft. I used lotions morning and night spending a lot of time caring for my feet. Soon they were soft, no cracked heels and feeling much better. My feet had begun to deform, hammer toes and a small bulge on the inside of my right foot was showing.

However, when talking with Bonnie, she didn’t have the ulcers, calluses or deformities. Yet, she had the same pain and difficulty walking that I did. She had taken better care of her feet. Apparently, the destruction was internal, inside her foot. The bones were deteriorating and becoming weak. Thus the broken bone that led to amputation.

None-the-less, foot care is really important. I have my poditrist check my feet and trim my toenails because I managed to cut the end of one of my toes off several years ago because I could not feel the end of my toe. Seeing the blood gush from my toe convinced me I should not try this again. P2170016Plus the nails were getting thick and hard to cut. Anyway, I told him the end of my big toe was hurting some this past week. He said my toenail was growing in such a way that I was getting an infection. That, I definitely did not want to hear. Fortunately, after he worked on my nail, it felt much better. I think it was rubbing on the inside of the shoe which didn’t help.

My next step, now, will be to go to the orthotics clinic. I had noticed a small callus starting on the ball of the left foot. The podiatrist gave me a prescription to get new orthotics. I see the podiatrist every three months, or sooner if necessary. After the appointment, he said my feet were stable. This was good to hear, as I am doing more walking and exercising.

From what I can tell, most of us that have had, or do have foot problems wait too long to seek help. When we do, the person we go to often doesn’t have the knowledge about the problem, such as Charcot Foot. Then the out come is the fact we are so bad that amputation is the result. They find it is easy to blame your weight if you are over weight. Then tell you, you need to loose weight, or diagnosis you with something that has similar symptoms.

Please use common sense and find the knowledgeable provider. Seek medical help as soon as a foot problem develops. Do not wait until you have to go emergency or urgent care for treatment.

Bonnie’s continuing story
This post was written by Bonnie Ribitzki a Charct amputee and friend from Gering Nebraska

Brought to you by Charcot Awareness Education Foundation

CHARCOT SURGERY AND COMPLICATIONS

January 10, 2004, the day I arrived at Providence Hospital in Anchorage by ambulance, started a wild roller coaster of four months. I had already spent the past three months at home on the sofa with my foot elevated dealing with wound care and an infection.

Now, the Doctors had to get my immune system and sodium levels up to be able to do exploratory surgery on my left foot. There was the strong possibility of amputation. Amazing that it took 8 days of meds, antibiotic drips and blood transfusions to get me prepared. I can not remember much of that 8 days for some reason, but I just don’t.

Before I started writing this, I called friend Sharon and asked if she remembered how I was responding to all this. She says I was pretty calm and just ready to get it over with. The day of surgery, Tony came in to see me. Since he was owner and operator of his truck delivery business, he had to work. Sharon sat with me at the hospital reporting by cell phone to Tony so he knew how the day was going. The Orthopedic doctor, Dr. Chang, performed the surgery. When he came in to see me, after surgery, he told me he was sorry he had to amputate, but the good news was the amputation was just up to the ankle. So, of course, that made me very happy. (Seriously, I don’t remember how I felt, but don’t remember being happy.)

After surgery, about two days, they had me trying to set up. The room was spinning big time. I was very nauseous. It took a few days of practice to pull myself up with a pull bar. (can’t remember what it’s called) After a few days I made it to the edge of the bed. My muscles were so weak (from laying on the sofa for 3 months with foot elevated). Then came the process to learn to use a slide board to get from the bed to chair and back again. This was quite challenging. Again a day or two process, but conquered it. Then about 10 days after surgery, the attempt to stand using my right leg and a machine to hold me up failed. My right leg was like a noodle. I could not hold myself up with the aid of the machine and fell to the floor hitting my stump. Boy, did everyone jump through hoops to get the screaming, hurting lady in bed. Of course, the wound started bleeding, but no sutures were pulled out (a blessing). Sharon asked me if her pastor could come to visit me and I had given her my OK. During this time Sharon was bringing her pastor, Pastor Suzanne Wood to visit and pray with me.

The wound was healing well, but since I had MRSA, the strong antibiotic drip continued. Any visitor had to wear a gown, or mask, even hospital personnel. I was receiving so many calls from relatives and friends wishing me well. My room was full of flowers, stuffed animals and cards pinned on a big board. It was overwhelming to think I deserved any of this. My wonderful friends in the airline industry were working behind the scene on a surprise.

The bandage was changed every day and healing going well. My pain levels were not too bad. Plans were being made for me to start thinking about rehabilitation, and going home to a three story condo. I was getting stronger and stronger. About the 10th of February, I awoke to incredible pain in my left thumb and forefinger. My right thumb was swollen, red and also, in tremendous pain. Now, a big rush to find out what was causing this. After tests, it was diagnosed as gout by Dr. Lee. She prescribed Vioxx, an inflammation reducing medication. Vioxx was fast acting. That’s for sure – pain subsided, as did the swelling.

But in a matter of 24 hours, I was having major problems. I started swelling up, could not urinate, had a very high temperature and listless. The heart doctor and kidney specialists called for all kinds of tests. They moved me to ICU without calling Tony, or Sharon. It took several days for them to realize it was my kidneys. The tests started rolling one after the other and the doctors not agreeing on what was happening. I don’t remember what was going on, but with kidney function gone, my body was filling with fluid fast. I remember being taken to a room with a huge machine and being hooked up to it, and all of a sudden feeling like I was freezing cold. I didn’t realize it was a Dialysis’s machine. I did not realize that those who loved or cared about me had not been told where I had been taken. It took the hospital staff awhile to figure it out as there had been a shift change. Needless to say Tony and Sharon were quite upset.

This post was written by Bonnie Ribitzki a Charcot amputee and friend from Gering Nebraska

Brought toby Charcot Awareness Education Foundation