May 13, 2009
Infection: When ATR Recovery Takes a Major Detour
Posted by booklady under Uncategorized
To treat the bone infection that resulted from my wound complications, I started my antibiotic IV treatments on April 15 (U.S. Tax Collection Day for our international bloggers), and it’s hard to believe four weeks have gone by . . . only two more weeks to go, if all goes well.
My two-hour infusions are part of my daily routine at 4 a.m. AND 4 p.m., and I never thought that I could get the procedures down well enough to administer my drugs as if it were second nature.

Meet my PICC line. It’s a catheter inserted above my inner elbow. Its dressings are changed every week and sometimes the plastic waterproof tape causes blisters. The site is painfully swabbed in alcohol at each change. Think alcohol poured on an open wound. It’s like that. I keep it dry to avoid infection at the puncture site. A foot-long hose dangles from it, and I attach it to another six-foot long tube to connect me to the IV bag. I’ve given up on covering it with sleeves as our Hawaii winter weather went from the 70s to the summery mid 80s in a matter of days.
I worry about . . . AIR BUBBLES!! Since I keep my meds in the refrigerator, champagne bubbles form in the IV bags as it meets up to room temperature. I have learned how to gently tap the bag to release the bubbles to the top. I’ve also learned how to flick out the smaller ones that run down the tubing by “strumming” it to the tune of Don Ho’s “Tiny Bubbles” :) These bubbles, when collected together, can form an air pocket an inch long — a bit worrisome for me, as the last thing I need as an airhead is a brain embolism.
My nurse friends tell me not to worry, however, because takes an air bubble the length of the six-foot tubing to really cause problems. The problem is that I’ve slept through several infusions where the chamber has dripped dry and the end of the liquid line was halfway towards my PICC line. Luckily, I’ve woken up in time to catch this grave mistake. My guardian angel always works overtime for me.

Here are my tools of the trade. I have to keep them correctly sequenced, especially at 4 in the morning. I swab my PICC tubes four times after every syringe injection. I have to be careful to always flush my line with saline because my Vancomycin cannot be mixed with my last syringe of Heparin. If they cannot interact with each other in my IV, I really wonder what happens when they mix in my body.
I log my beginning and ending times and remind myself to change my administration tubes every other day to keep things sterile. I record my reactions and I have found a happy medium in timing my drip speed so that I don’t have to take Benadryl to counteract any reactions. A smooth, reaction-free drip now takes me at least 2 hours. Any faster, my heart starts palpitating and a simple brush to the skin is enough to set off a massive hive attack. It is a battle of will not to scratch.
So . . . has all this hassle made the difference?
Yes:
- because my wound did dry up and the opening did close a little
- the swelling has gone down to the point that my “cankles” (calves + ankles) are not as pronounced
- so that I can say that I did give this treatment a chance to fight off my bone infection
No:
- yet another lesion — my third one — has emerged and popped this weekend
- I’m always in pain — #5 on my threshold level
- I still can’t do a simple supermarket run without being totally exhausted and in extreme pain
This is leading me to believe that though the drugs may be working on the infection, the tendon and my reaction to the sutures continue to cause me problems. I’ve been on medical leave for the past 4 weeks and just returned to work for one day. Though I was careful, it was tough.
My last follow-up visit with my orthopedic surgeon had us discussing a tendon transfer as well as a debridement to get the bad tissue out. It all sounds so invasive, that I’ve made the decision to see another ortho for a second opinion and to see if her plan matches my current doc’s plan of action.
In the meantime, my clothes are fitting more snugly . The extent of my exercise are pulling my jeans on and doing the contortions needed to compose the photos for this post. I miss the endorphine rush that helps me feel whole, as if I’m taking care of myself.
It still remains a journey, this detour into the dark valley called infection. Web research on bone infection gets discouraging as concepts such as “amputation,” “lifelong antibiotics” and even “death” come up too frequently to be hopeful.
My friends remark how well I seem to be taking these setbacks, and for the most part, I can be postive. Normally stoic, I am finding that it now doesn’t take much for me to lose my composure. A call from a special friend, or a sincere, “No. Really, how ARE you doing emotionally,” are enough to get the tears flowing.
I am thankful that my crutches and boot have served their purposes for now. I can walk, albeit slowly, and I have adapted to the nuisances and inconveniences of my affliction. I draw from the reserve of rest gained from limiting my schedule and my medical leave. I have learned how to receive help openly from my family and friends. I realize that my condition is now beyond me and anything I can do to control it. I don’t know what future conversations about my ATR plans will be like, but I have learned to live these moments in complete surrender to God, knowing that I am “fearfully and wonderfully made.”
I pray for the effectiveness of all this medication and effort, and in the quiet and isolation of my 4 a.m. IV drip, I go before our living room window to wait for the chirp of the first wakeful bird and the promise of dawn that follows it.
A belated Happy Mother’s Day to all the ATR moms out there . . . ~ Booklady

May 13th, 2009 at 4:44 am
Booklady, that report is ’staggering’ I am amazed at how well you have done and how methodical you have become in administering your medication. You deserve a medal for the way you are nursing yourself.
As for the ’snug fitting clothes’ think we have all suffered from the same thing.
Take care
Annie
May 13th, 2009 at 5:35 am
Booklady,
Wow, I can’t even imagine. I am so sorry you are having to go through this. I am sure facing another surgery is a crazy thought as well. Please let us know what your second opinion tells you. Also sorry your pain level is staying pretty high. I know what that feels like and it can get maddening. Hang in there! My thoughts and prayers are with you.
May 13th, 2009 at 1:23 pm
I am now in my 5th month…I could not believe what happened to you…I could really relate to your pt…I have not felt that I am improving in the last few weeks even though the therapist say I am..You are a very strong person and I am praying for you recovery. Write me anytime…RheaSue
May 15th, 2009 at 6:28 pm
WOW. Thinking of you and I know your ordeal will be over SOON! The meds will kick the infection. I didn’t have it as bad as you…My MRSA was licked in a few weeks by seeing an Infectious Disease Dr. My wound did take 6 mths to close, and I’m now at 1 yr 1mth post op and still wouldn’t get in a swimming pool bec of this scab wound thing. I can’t imagine how difficult it is for your world to be temporarily revolving around your IV treatments. GET BETTER SOON! There is light at the end of the tunnel and soon you’ll reflect back wondering where the time has gone.
HANG IN THERE!