Monday, August 31, 2009

Well, my friends . . . I got thrown a little curve ball today. Thought I better share . . .

Since I last wrote, I have been LOVING school, and working on walking with my boot. I am hooked up to my VAC again so my students have the pleasure of watching my body juices slowly move through the tube as I teach my lessons. The VAC also makes intermittent fart-like noises that are always appreciated by my amazingly mature students. :)

Last week at Wound Care, I expressed that I was still feeling a lot of pain when I tried to walk. So, Dr. Carbonell asked that I come to his office to get an injection of some stuff that would bring down the swelling around my ankle--and hopefully make walking less scream-out-loud-painful. Not only did I end up getting the shot, but Dr. Carbonell assessed that most of my pain was being caused by tendonitis. Therefore, he fit me for a brace, told me to try to flex my ankle a little more to start building strength in the muscles and tendons, and set me up to start physical therapy.

My students were SO excited to see me wearing a regular shoe and "walking" with a walker on Thursday morning. I almost felt like this was the beginning of the end . . . My wound was humming along on the VAC and I was flexing my ankle in a "walking" motion. I could almost see my wound being closed and walking with a cane by Christmas.

Insert here: curve ball.

On Friday night, I was practically crying out loud at the excruciating pain in my Achilles. Forget about the brace--I was moving back to my stable, non-flexing boot.

On Saturday morning, I noticed that my VAC tube was full of greenish looking mucus. Sure enough, when I went to change my dressing on Saturday night, it was OBVIOUSLY infected again.

I called Dr. Carbonell on Sunday morning and he called in a prescription for more antibiotics and told me to come in first thing on Monday morning.

Well, here is what we found out.

We now believe that there is a deep infection in the bone. Despite 5 months of major IV antibiotic treatments, the original infection was probably never killed from inside the bone. Although we kept it at bay for a while, it is coming back over and over now and using my wound as a drainage spot. This would most likely explain why my wound has not healed.

The x-ray taken today also shows a large area on my talus bone that is gray rather than bone-white. The gray area either indicates bone death or infection. We knew that the bone had died in some areas, but that should have stopped at the 6-month point. The fact that the gray area has grown significantly in the last 2 months seems to be another indicator of bone infection.

So . . . I am going back to my infectious disease doctor (good 'ol Dr. Jacobsen) on Thursday. He and Dr. Carbonell will discuss how to proceed then. Most likely, I will be going back on long-term IV antibiotics (PICC line in the arm, balls of antibiotics in the refrigerator, injecting myself every 8 hours) and having surgery to take multiple bone biopsies. If the bone is indeed infected, they will either try to treat the bone to kill the infection, or start removing the bad bone. If they have to take away too much, the ankle will be basically useless and will have to be fused.

Basically, rather than seeing the light at the end of the tunnel, I am now a ways back at the entrance.

I feel a bit like I have been hit in the gut. I had a moment or two this afternoon where I felt like I was drowning in the whole situation. I can not STAND to see the sick look on Doug's face when he finds out stuff like this. I hate to do this to him again.

However, on the whole--I feel like it makes good sense. It is do-able. It is not going to kill me. I am in good hands. We will make it. No freaking out is necessary. God has a plan (He always does).

The End.

P.S. I will write you to tell you what happens on Thursday with Dr. Jacobsen. That appointment will be VERY interesting.