Saturday, January 29, 2011

MRSA

So, the hand?

It was MRSA.

It snowballed, big time.  It got worse throughout the day on Friday the 21st.  Went to the ER that night when Derek got home from work.

The doctor frustrated me... not because he was a bad doctor, but because he didn't listen to what I was saying.  He felt a second course of antibiotics was the best choice.  That is pretty standard when an infection recurs.  He also felt that since the first course did impact it, he'd use the same kind again.  I disagreed, but he is the doctor, not me.  I repeatedly voiced my concern that this was eerily similar to the progression my leg initially followed this past spring, but he assured me this was very different.  However, he did refer me to the wound clinic.

Monday, things were not any better but hadn't worsened drastically, either.  Talked to my doctor, told him how I felt, and he told me I needed to be seen that day.  I told him they'd refused to work me in until Tuesday.  He called them, and then called me and said that the infectious disease doctors said it would be fine to wait.  He told me to go in if things got worse quickly or significantly. 

Overnight Monday, my fever went back up to 102.3, which is not the 103.9 that it had been.  I didn't sleep at all, until about 4:30 or 5:00 AM.  I slept through until noon, then got up to get ready to go to the wound clinic.  I freaked out when I looked at my hand - it had grown a lot in the 7.5 hours or so I'd been sleeping, and I felt super crummy.  I knew they'd probably admit me or at least run a dose of IV antibiotics, so I brought my backpack with my phone and charger, my favorite pillow, and books to read.

The doctor initially seemed very calm - rude, but calm.  He sent me for blood work and x-rays - I've never walked into the lab with red-edged orders before.  It gets you to the front of the line.  (Note to self - if ever in a hurry, bring a red sharpie for lab appointments.  Kidding.  Mostly.)  In the 30 minutes it took to do those things, the redness visibly darkened and the swelling increased.

My appointment was at 2:00.  At 4:00, I was getting settled into my hospital bed after having seen the infectious disease doctor and the orthopedic/hand surgeon and having had really big, long, painful needles jabbed into my hand in an attempt to aspirate "infectious matter" for pressure relief and culture.

It got worse throughout the evening Tuesday.  Wednesday, the put me on a PCA pump (pain control) with fentanyl, and I was getting pushes of tordal and taking hydrocodone by mouth.  My hand was so swollen that the skin started getting dark red lines where it was starting to tear.  My temperature was fluctuating up to 103.  They had me on rocephin and vancomyacin.  Plus the zofran and benadryl and pepcid to control the effects of the vanc. 

Yesterday, things started to pick up pace improvement-wise, but the pain changed and worsened - the smaller my hand got as the swelling went down (and the bigger my forearm and elbow got as they continued to sell), the worse it hurt.  The doctor on call was a fairly new resident, who insisted that there was no reason for the pain and chose to discontinue the PCA pump and cut the amount of pain-relievers down to 1/16th of what I'd been getting right up until she made rounds.  Talk about a loooooong night.

This morning, the regular attending came in, took one look, and got me some hefty doses of the meds I'd been given previously, and they didn't really help.  I saw my hopes of going home slipping out the window, and slipping fast.

Neurology came in and found that my ulnar nerve is very displeased with all that's gone on and has ceased proper function starting just above my wrist.  I was told it will recover, but it'll take "up to two months."  Two months... I can handle two months.  I don't like two months, but it's better than forever.  Besides, I have a God who is bigger than one tiny little nerve.  And they gave me... something... for which I can't remember the name.  It's a medication that was made to treat seizures, but didn't work for that, but someone noticed that in people with nerve damage, it really helps that sort of pain.  That medicine, paired up with hydrocodone and ibuprofen (and zofran) got things under control.  I went to occupational therapy, got to sit with my arm in a whirlpool and then get a thorough massage, and then they gave in and let me go HOME.

It feels so good to be here, in my house with my cats and ready to crawl into my very own bed

And it turns out, the infection was MRSA.  I've got five more days of oral antibiotics and then in a week I follow up with infectious disease.

Moral of the story?  Apparently, it's that you should go to the hospital every time a blood draw results in more than a super-tiny bruise.

Okay, not really.  The actual moral is that if you jump on top of infections early, like was done this time, and you get proper and prompt treatment... you may still spend hospital time, but they don't have to start chopping chunks of flesh out of your body.  I'm thankful for my friend being pushy and not letting me shrug it off or say "oh, it can wait."  Thankful for my doctor being mean and riding me about getting it rechecked sooner, and calling infectious disease to make them get me in sooner (they were going to give me an appointment Friday, i.e. yesterday).  If not for those two, I'd have crawled into bed and gutted it out until Wednesday or maybe even Thursday before going to the emergency room, and it'd have been a much longer road to recovery, probably involving surgery and permanent damage.

Also, if not for those two, the information board by my bed wouldn't have had the following on it:  APPTS (supposed to be an abbreviation for appointments) - No, she lives in a house.  Get it?  I know, I know... apartments only has one P, but it was funny at the time.  The doctor and friend thought so, especially.

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1 comment:

Amanda said...

I'm glad you're home!! I was hoping, when I didn't see you at church, that you weren't still in the hospital. and it was MRSA? shoot! that would make sense then....