Just as advertised. Had a gnarly infection in my foot that got to the point of nearly losing it. And it happened fast. It was just annoying for a week or two, went to urgent care to get it looked at, they gave me antibiotics, and four days later I was in the hospital getting a pile of tests done and pieces of my foot were being cut off to keep the rest of it attached.
This is easiest to do as a timeline, so here we go.
Sometime in June before vacation: I use my thumbnail to peel a callous off the bottom of my right foot. Thanks to my neuropathy, my foot has gone pretty much numb and I go too deep. No big deal, I’ve done this before. Just have to pick at the remaining dead stuff as it heals so it heals evenly.
Late June-8 July: foot starts to really hurt, and there’s some pinkish-purple discoloration on the side by where the hole was. And by “really hurt,” I mean “constant pain punctuated by shooting pains that feel like someone driving nails into my foot.”
9 July: take a Vicodin, go to urgent care, get antibiotics, go home.
11 July: go out to some friends’ house for a small party and to discuss plans for The Event. The antibiotics aren’t doing much, so I end up taking another Vicodin. Getting serious shooting pains in my foot and lower leg.
12 July: foot is turning purple and hurts so bad I can barely walk. The oral antibiotics aren’t doing much. Stacie gives me the choice: ER now or urgent care in the morning. Since an ER trip typically costs me a couple grand and I’m still stupid enough to think it’s no big deal, I wait.
13 July: no improvement since the night before, so we go to urgent care when they open. Urgent care doc takes one look and sends me to the ER for IV antibiotics. ER docs take one look and say they’re keeping me.
Among other fun in the ER and hospital, I get X-rays, an MRI, and “bedside debridement.” “Bedside debridement” is the polite term for “dude comes in and starts carving chunks of dead meat and infection off of you. Without anesthetic.” Every time he touches the side with the wound, I damn near jump straight up off the bed.
The room is amazing, though, so I can’t really complain. Then the MRI results came back, showing I had a nasty abscess.
Because I’m just smart like this, my entire food intake for the day until about 6:00PM was a handful of gummi bears and a glass of milk. Figured I’d hit a drive-through on the way home from Urgent Care. Yeah… Wouldn’t hit a drive-through until Thursday night. So I got my first taste of the hospital’s room service. Chicken and mushroom marinara on some kind of curly noodles, mac & cheese, Greek yogurt, and milk. Good stuff.
Sleeping was fun. Between the uncomfortable hospital bed and the IV tube, it was hard to get into anything resembling a comfortable position. The dilaudid helped though. Elvis Aaron Presley did it ever help. Takes you from “owowowowowow” to a weird pressure behind the bridge of the nose to feeling like you’re being massaged to sleep by pillows in a matter of minutes.
Oh, and since they were waiting for the podiatrist to look at the MRI results and OR availability, everyone operated on the assumption I might be having emergency serjury as soon as I woke up. So no food or drink after midnight. No food, no problem. But I drink quite a bit over the course of the day; it’s a diabetic thing, I get dehydrated.
14 July: podiatry analyzed the MRI results and decided they needed to do more carving. However, they couldn’t get me into an OR until at least Wednesday so they did the procedure in my room. 4 shots of lidocaine and about 45 minutes of carving later I had a freshly-wrapped foot. And a really tasty omelette. Mushroom, ham, and swiss, with milk and a cup of tea. That wound up being breakfast the next two days.
Then it was just sitting around doing nothing. The pain was bad enough that I spent a lot of the day stoned on dilaudid, and I know I dozed off a few times. Night food was chicken teriyaki, confetti brown rice, cole slaw, and tea.
15 July: more sitting around seeing if things were getting better or not. Met the infectious disease doctor. She basically explained that they were still waiting on cultures from the gunk they had scraped and squeezed out of me to see what exactly was going on. So I’d probably be there another day. And I was. Tried the Swedish meatballs that night. Not bad.
And managed to take a shower. Things were doing better to the point I could do it without having to have any of the nurses actively assist. Kirsten got me disconnected from the IV and bagged my foot, showed me how to operate the shower, and I was good to go. It was nice scraping off the slime I’d extruded over the last couple of days; the room temperature kept fluctuating, I was running a mild fever, and I had a pretty gnarly infection, so I was pretty gorram rank by Wednesday afternoon.
As of that night, the plan was to send me home with a wound-vac and IV antibiotics. Whee.
The wound-vac was option 2 of the three available.
#1 wasn’t going to happen without something going horribly wrong; it involved cutting off one or two toes and using the skin that freed up to close the wound. Yeah, no. The doctors weren’t entertaining it either; it was kind of a “hey, in theory we could do this if we really had to,” kind of deal at best.
#2 was the wound-vac. It was kind of a pain, but it should cut recovery time and reduce complications. “Complications” in this case meaning “the infection comes back and we cut your toe off.” Requires a nurse to come out three times a week to rewrap it and give it a good look. The repeated nurse visits alone make this the best option – neither Stacie nor I know what we’re doing, and a nurse does. If something gets weird, the nurse will know it.
#3 was to wash and wrap it every day. Longest recovery time, and with the critters kind of a high risk of reinfection. Plus I’m stupid enough to decide it was good to go too soon and wind up back in the hospital.
16 July: a third podiatrist stopped by to look at it. He said the wound looked “healthy,” and that it was “promising.” I’ve had this doctor look at the cellulitis in my other leg and foot a couple times, and he doesn’t screw around or sugarcoat things. He’s basically House. Comes in, examines the issue, and tells you what’s up without the “Minnesota nice” routine. So when he said it looked healthy and that things were promising, that was huge.
Then the infectious disease doctor came back to tell me what they’d found out. Two separate infections. One was a strep infection, the other something I can’t pronounce that’s found in human dung. We’ll get back to that one.
She said strep infections can go from zero to sixty in no time, which explained why they urgent care response on Thursday was “have some antibiotics,” and on Monday it was “ER. IV antibiotics. Now,” followed by “we’re admitting you as soon as a room opens up.” She went on to say she had seen strep infections go from no big deal to losing a limb in the space of a day. And that I’d probably gotten there just in time.
That other infection gives me an idea how this all happened. Our shower drain was running slow, so I’d been soaking my foot in it as I took my shower for several days straight. I don’t know about the rest of you, but I wash my butt in the shower. So I’d been marinating my foot in poo-water. Usually, this would be no big deal – I wash my feet too. But with the open wound on my foot…
Right at noon, I get a visitor. It was the person from the in-home nursing service that was going to take care of the wound-vac and make sure I wasn’t completely screwing up the IVs I’d have to self-administer. She walked me through the process to the point that I figured even I couldn’t screw it up too bad, then left.
Thirty seconds later, the nurse comes in and tells me I’m not doing IV antibiotics. Turns out the antibiotics they were looking at were pretty hardcore. Hardcore enough that especially being diabetic they were something I really shouldn’t be doing at home because they might fry my kidneys. So there’s a bunch of weirdness sorting out some proper oral antibiotics.
Spent the rest of the afternoon waiting for discharge papers and Stacie to come pick me up. Because my discharge time was a constantly-moving target (starting at 4:30 or 5:00, then noon, then 3:00), I never bothered to order lunch. Finally left around 5:00. Swung by Raising Cane’s on the way home and went to gorram bed.
17 July: nurse came over to explain the wound-vac and do the first dressing. It’s a pretty cool device. Little vacuum pump you carry around in a little shoulder bag attached to the wound by a long tube. On the wound end you have some foam packed into the wound to fill the cavity and act as a transport medium for the infection. Then they wrap the whole area in clear plastic kind of like big, heavy Scotch tape. So far the only downside is the tube. It’d be nice if it was about a foot longer; between the length of the tube, my height, and the position of the wound, it’s really hard to get comfortable at night. For showers or whatever else, I can temporarily disconnect it using a couple of clamps, but it’s intended to be worn as close to constantly as possible.
20 July: foot still hurts if I forget my Vicodin, but I’m down to one every 16-20 hours. I can more or less walk, but if I step on the wound itself it feels like a tack being driven into my foot, and the wound-vac itself is a major mobility-killer. The tube is about a foot too short (probably to maintain good vacuum) because I’m fairly tall, and the unit weighs about ten pounds. So even if I wasn’t under doctor’s orders to stay home until it’s done I wouldn’t be in any position to go back to work yet.
Doing the short-term disability paperwork this week sometime. Have to do part of it myself, my doctor does another part (seeing her on Wednesday), and HR does the third part. The checks won’t be much, but they’re something and nobody expects me to be out of work for all that long. The worst estimate I’ve heard is a month or so, and the best is a week or so. So I’ll likely get one or two STD checks and then get back to work.
Last but absolutely not least by any stretch of the imagination: a special thank you to the nursing staff that took care of me while I was there. All of you were amazing, especially the four I had the most contact with (in the order I met them): Kirsten, Lydia, Lisa, and Jessica. You all went above and beyond, and I thank you again for your efforts. You helped make a pretty bad situation a lot more bearable, and I really hope I wasn’t too much trouble.