PANAMA CITY — For days, Lorraine DePriest has been patching the hole in her abdomen with only toilet paper and clear packing tape.
They're the closest things to medical supplies the 55-year-old in Panama City public housing has after Hurricane Michael swept through and destroyed the small monthly stockpile of colostomy bags she has relied on for years.
When the storm's driving rain soaked through the bags she had and mildew crept in, DePriest washed and reused her single remaining bag until it became unusable five days later.
"I wasn't going to put mildew on this," she said, tapping the opening covered by wadded tissue and tape. "This is a desperate need right now. I don't care about anything else."
Patients like DePriest were already struggling to access healthcare before Hurricane Michael, but the storm has exacerbated those hardships into impasses.
Some need as little as a few dollars for gas to refill prescriptions at a pharmacy or get checkups before surgery. Others have doctors whose offices blew away or they need tanks of oxygen to breathe. Some patients, tending to their families, worry about scheduling appointments for children — or prenatal checkups for mothers and babies yet to be born.
What remains for them in Michael's wake is dread, doubt and an uncertain timeline for a return to normal healthcare.
It can take years for communities to recover from a disaster as devastating as Hurricane Michael, said Dr. Patricia Cantwell, a pediatrics professor at the University of Miami who has worked in disaster zones for more than two decades. In such all-encompassing emergencies, the intricate infrastructure of healthcare often shows some of the first and longest-lasting cracks.
"I can't begin to imagine the desperation people face," said Cantwell, who went to Panama City as a medical manager for the South Florida Urban Search and Rescue Task Force 2 after Michael. " 'Where am I going to get supplies, where am I going to get water, how do I get gas to get there? Who's going to drive me?' Their whole means of being is just shot."
"An event like this can knock somebody totally out," she added. "Just medical transportation — which is a challenge on a good day — is astronomically worse after an event like this."
And avoiding the storm by evacuating is resource-intensive, too: "How could you possibly stay here? When one thinks about it, it's expensive if you don't have anywhere to go, you don't have the gas money to get out."
At Surfside Middle School in Panama City Beach, where about 200 people are residing in a designated shelter, Daisy Daniels, 63, struggled to ask some AT&T workers about replacing her cellphone.
Daniels lost most of her hearing when she developed vertigo in the spring. She taps her left ear — her hearing is all gone — and says her right ear only allows about half of the sounds of the outside world to filter in.
She went to an office in Lynn Haven for a hearing test before the storm, where they gave her a pin — "please face me when you talk to me."
When it disappeared in the tumult of the storm, a shelter volunteer fashioned a makeshift necklace for her out of yarn and construction paper with the same instruction so others would know how to communicate with her.
But she has still struggled to comprehend everything happening around her, relying on her son Solomon to explain what people around her are saying.
At a nightly shelter meeting, she said, "it was so difficult I had to ask him to tell me everything."
Daniels needs medications from a pharmacy in Panama City, over the bridge, where she had been in a different shelter before the storm. But they ran out of gas after getting there, and the car remains abandoned while they figure out when they can get back, she said.
Not far away, Miguel Rodriguez, 39, looked down at the brace supporting his left ankle outside. Rodriguez evacuated from his Panama City home ahead of the storm but came to the shelter after he got into a car accident while trying to return with supplies.
He wears the brace for an unrelated bone condition that makes it difficult to support his left foot, he said. But he is out of the medication he has been prescribed to manage the associated pain — and his doctor's office was badly damaged.
"The building is no longer standing," he said. "I don't know how much longer they're going to be closed."
The shelters have had a medical team to help transport residents with medical emergencies or help manage chronic conditions, said shelter manager Tony Sapien of the American Red Cross. At the shelter, about 30 percent of people are elderly, he added, and about a dozen have needed regular medical attention for conditions like diabetes.
But personalized care for ongoing conditions from a medical provider can remain disrupted for long stretches of time, particularly in an age where electronic records are held hostage by power outages and a lack of communication signals.
Sherri Matteson of Washington County was briefly hospitalized in Alabama after she lost power to run her home oxygen equipment after Michael hit, she said.
Matteson, 50, is in the final stages of chronic obstructive pulmonary disease, an inflammatory lung disease that causes obstructed airflow from the lungs. Around midnight after the storm hit, she ran out of backup oxygen tanks and drove to a hospital in Dothan, Alabama, for treatment. By the time she arrived, she said she was going into respiratory failure.
"It was a very scary ordeal," she said. "It was traumatizing, traumatizing, traumatizing."
After two days, the hospital sent her home in order to make room for more critical patients who were being evacuated from Bay County hospitals.
When she called her oxygen supplier, she said Tallahassee-based Lincare told her it was totally out of supplies. The Alabama hospital sent her home with two tanks of oxygen, and she was able to buy a generator and continue her home oxygen treatments.
She uses the generator to help neighbors nearby, and her young children help her fetch food and water. but she fears others are not so lucky. Much of her community is made up of the elderly, she said, who don't have the means to take care of themselves.
The lack of continuous care also extends to routine needs.
In Callaway, a Panama City suburb, 31-year-old Bricia Betsy worried her 15-month-old daughter might overheat without air conditioning, prompting her to use what little money she had to rent a hotel room for the week. But her daughter isn't the only young one Betsy worries about — she found out right before Hurricane Michael hit that she's pregnant with another girl.
She and her partner have already picked out a name, she said: Natalie. But they don't know how they'll make sure that her pregnancy is healthy without a doctor in town to provide prenatal care.
"I'm probably going to have to go out of town for that," she said.
Others with less will have to depend on chance.
DePriest, who is on Medicaid, also lost her cleaning solution, the adhesive she uses to attach the bags and her diarrhea medicines to Michael's destruction. She asked Red Cross workers, FEMA workers and police officers who passed by the ruined housing complex she has been living in for colostomy bags, but none had any on hand.
An EMT worker said they'd bring some, but "nobody's coming through."
"I've been asking everybody for help and nobody listens," she said.
She's afraid of getting sicker. She doesn't know where she'll live next. But until then, she said, her only option remains reaching for more toilet paper and tape to try and keep her condition in check.
"I'm not getting the help that I need," she said.
Miami Herald staff writers Alex Harris and Samantha J. Gross contributed to this report.