Foot 2021, Part Two

So I wound up in the hostibule again…

More or less the same problem as last year, but on the other foot. Wednesday a week and a half ago, I had a follow-up after work.  Doctor looked at it, said I needed to stay off it as much as possible, wrapped it back up, and gave me the next five days off from work.  This wasn’t an offer or discussion, this was an instruction.  I was going to have a five day weekend whether I liked it or not, and I was going to spend that weekend doing as little as humanly possible, ideally lying in bed the whole time. 

OK, no big deal.  I suspected the walking around at work was slowing down my recovery.  A few days horizontal were literally just what the doctor ordered.  Had X-rays after the appointment and an MRI Friday. 

Went in for the follow up on Monday, and he had a look when he opened up the bandage.  The MRI showed that despite our best efforts the infection had spread into the bones.  I had an infection in the bone of my little toe and the bone behind it in my foot.  He explained what this meant in terms of severity, risk of spread, etc. 

Not.  Good. 

So I said “I’m missing some more work, I take it?”  Because I’m, you know, smart. 

His response was that I should count on missing at least four to six weeks. 

Then he got a different look.  The one that said “I like my job, but man do some parts of it ever suck.”  And then he told me my best option was to lose my little toe and part of the bone in my foot.  The other option was a hospital stay, bone biopsy, IV antibiotics, and the possibility of that not working, the infection spreading, and losing even more of my foot.  Either way I was being admitted on the spot.  Which was really weird considering it didn’t hurt that much.  It was unpleasant, but not bad.  Go neuropathy. 

Conversations like that are why I didn’t even consider going into medicine.  Imagine how hard it is to tell an adult they basically have the choice between losing a toe and losing a foot.  Now imagine telling that to a little kid. 

So while he was making arrangements I called Stacie to let her know what was going on, then thanked my forethought to throw a few things in my backpack just in case.  Then he dropped me off at hospital admission and went back to the clinic to finish the rest of his schedule and arrange an OR for either the bone biopsy or amputation.  Meanwhile I got checked into my room. 

Then I got to sit there.  Waiting.  And debating.  Nobody had any idea when they’d get me into an OR, just “after noon,” because the doctor had clinic until then.  So I waited and debated. 

A little before noon they let me know I was scheduled for just after noon, which surprised everyone.  Apparently the original ETA was closer to five that evening.  Whatever.  The sooner the better because it got done sooner.  Whichever option I chose was going to suck, but at least it would be done. 

Then they wheeled me down to OR prep, had me change gowns, put on a hair net, and talk to my doctor.  He came in looking simultaneously concerned and like he had a speech prepared.  Sure enough, he started explaining the case to be made for the amputation.  I let him talk for a bit, then said “yeah, sounds like that’s my better option.  Do it.” 

A little while later they wheeled me into the OR and knocked me out.  Woke up in recovery where they gave me some oxy, then got sent back up to my room.  The next two days and change went about as you’d expect except for two small disappointments and two discoveries from room service. 

Going to the bathroom was a gorram adventure.  Because of how the room was laid out I was best off getting out of bed on the side away from the bathroom.  So despite the bathroom door being almost within arm’s reach of the bed it wound up being a walk around the foot of the bed, plus the four feet to the bathroom, and another few across to the toilet.  Doesn’t sound like much until someone chops off your gorram toe and part of your foot.  Thank Elvis someone had dropped off a walker for me to use.  I am pleased to report that I didn’t need the nurses to help me to the bathroom at any point in my stay. 

I had meetings with Physical Therapy, Occupational Therapy, two other podiatrists, the infectious disease doctor that had done my final follow-up last year, another doctor, and a social worker Tuesday and Wednesday. 

PT watched me walk with the walker, gave advice on how to get around and not hurt myself, and showed me how to climb the stairs without falling right back down them.  Important considering I’ve been confined to the upstairs since I got home and will be for some time – aside from doctor’s visits I am to stay upstairs.  Ideally I’ll spend that time lying down and only getting up to use the bathroom, but they also cleared me to sit at my desk.  OT covered a lot of the same ground as PT, which was nice. 

The podiatrists changed the bandages and examined the sutures and stuff.  They both said it looked good.  They also told me if I have to walk, I should only apply weight to my left heel.  Other than that my left leg is “non weight bearing” until things start healing.  As a fun side note, the first of the two was the same guy who was cutting chunks off my other foot without anything to numb it up last year.  Good times.  We laughed about it. 

The other doctors figured out my meds going forward.  IV antibiotics three times a day and Vicodin as needed for the pain.  Then the social worker set up the in-home nursing service to help with the IV antibiotics. 

By the time I left Wednesday night pretty much everyone was remarking on how well I was getting around despite losing the toe.  Which is a Good Thing. 

Back at home my life largely consists of lying in bed, staggering to the bathroom, staggering to my office to do my IVs, and using Stacie as my personal servant.  Which is fun and a half – I married her to be my partner, not my slave.  But since I’m not supposed to climb the stairs any more than I absolutely have to and her definition of that is “if the house is on fire or you’re going to the doctor,” I don’t have much of a choice. 

The IV antibiotics are interesting.  To take them I had a PICC line installed.  That’s an IV in my left arm that trails a tube to just outside the main pump.  As a result I have a ten pound lifting restriction on my left arm and orders to pretty much just lie or sit around the house until it comes back out. 

To do the injections I get to go through a whole ritual of flushing the line before and after the antibiotic injection.  The flushes aren’t bad.  They’re room temperature, so the end of the metal part in my arm gets a little cool.  As for the antibiotics…  They’re in the fridge.  And I can’t inject them all at once or I’ll get really nauseous according to the nurse.  So I do the first flush, screw the antibiotic syringe into the IV line, and administer two lines worth every minute or so. 

Every time I push antibiotics, two things happen.  First the metal part of the IV gets cold.  Not painfully so, but unpleasantly so.  Then I get this weird pressure in my chest from the medicine getting dumped in right before the main pump.  It’s gorram trippy, and not in a good way.  Not sure if it’s just pressure or partly the cold from the refrigerated liquid, but it’s weird either way. 

And to answer the question everyone already knows the answer to but doesn’t dare ask, I have pictures and they are nasty.  My boss compared the stitches to the work of Dr. Frankenstein.  When I mentioned them to the nice lady in HR she instantly told me she does not need to see them.