Back in the hospital

Yep, that's where I've been since 9:00am yesterday. My parents brought me their old laptop today so I can follow my blogs, watch MSNBC online (hospital TV channels are extremely limited) and keep in touch with the world while I'm stuck here.

My last update was Saturday when I explained the wound issues that I was having. While I took the oral antibiotics at home my wound got nastier looking and was needing far more frequent dressing changes. Even though I was pretty prepared to be admitted when I got here yesterday, I was still a little surprised at Dr. Brumback's decisiveness. As soon as my leg brace was un-velcroed and he could see the dressing needed changed, he asked "When was the last time you changed that?" Hearing that it had been less than twelve hours, he said "You're going in the hospital today my friend," as he reached for fresh gauze pads still without seeing the wound.
He quickly redressed it and told me to strap my brace back up and to get comfortable while they made arrangements to have me admitted. Then began the wonderful game of hurry up and wait. After mom, dad and I spent about 5 hours of sitting in an exam room, nodding off, reading books, doing sudoku puzzles and took one field trip to the cafeteria I finally got a room at about 2:30pm. Mom and Dad were real troopers and we did our best to stay amused and keep each other company.

Once admitted I was visited by a phlebotomist who took two sets of blood cultures. One from each arm. Lots of fun....not. Each set was two Tabasco sized bottles half full and about 6 regular vials of blood. Good thing I was laying in bed and not going anywhere because I was quite literally and figuratively drained after that. Also got my IV line installed in a spot on my arm that I am not at all happy with (having it moved tonight actually). Eventually a physicians assistant came by to say that I was on the schedule to get surgery at 5:30pm today and couldn't eat or drink after midnight. The plan was to open the incision, clean the wound out, and re close it. At about 8pm they started me on IV antibiotics.

My friends Doug and Penni came to visit for the evening and we watched the thunderstorm out my window. I talked to several other friends on the phone and got a pretty good night's sleep.

This morning I was woken up at 6am by the nurse starting me on a new bag of antibiotics and by Dr. Brumback and his team doing rounds. He was pleased with the wound and how I was reacting to the antibiotics so he decided that he would not do surgery today (major relief). He also said that they would go ahead and feed me which was also kinda nice because I was finally starting to get hungry. I haven't had much of an appetite since Saturday and have only been eating one meal a day.

Later in the morning I got all my staples removed and a resident (or maybe a physicians assistant) poked around at the wound and changed the dressing.

As the day progressed I felt better and better. The antibiotics seem to be doing the trick.

I got a visit from Heather the associate pastor at my church who is a coworker and a good friend. Later on Mom and Dad arrived, followed by Danielle and then Becky (with butterscotch cookies). Good company, an appetite and the Internet all proved to be good for my soul as the antibiotics continued to be good for my body.

This evening I met with the doctor from the Infectious Diseases Team (or as I call him - the germ guy). After quite a few questions about my dreadlocks (he was quite intrigued) he explained what he thinks is going on, what the likely plan of attack will be, checked out the wound and took some cultures to send to the lab. He said that he would talk to Dr. Brumback; they are collaborating and approaching this as a team; and tomorrow they would discuss my options and we would decide how to proceed.

It sounds as if the most likely course of action will be for them to keep me on antibiotics for several weeks to keep the infection at bay until the metal plate and screws can be removed. The problem seems to be a reaction to the hardware that most likely started back in March when the original plate and screws were installed. Once they pulled that out and stirred things up it activated the bacteria which reacted severely to the new hardware. So as long as there is hardware in my leg there will be this reaction. The strain that they think I have does not travel throughout the body, but it does make bone healing more difficult. This is possibly why the first surgery did not hold and the bone collapsed. So even though it did not present itself externally it was likely the culprit for the problems I was having.

About an hour after the germ doctor left a resident from Brumback's team came in to say that they were restricting me from food and drink at midnight again and that there was a chance that they would end up taking me into surgery tomorrow to do the clean out after all. Apparently the germ doctor was not very happy with how the wound looked.

So after two very long days in the hospital I'm feeling much better, but still don't have a definite plan for what we are going to do. Also, after much relief from not having to go into surgery I'm again going to sleep with the possibility of being in an OR tomorrow. I can't spend too much time worrying about it though because obviously nothing is set in stone and things seem to change minute to minute.

We'll see what happens in the morning.