Week 5 - Stuck in Hospital
Was supposed to be discharged Monday morning. Monday morning came and went. Tuesday morning came and went. Still here.
Living alone in NYC, and in-between apartments when this whole ordeal happened to me, has been incredibly trying.
Let me backtrack. After getting my cast removed on 4/13, we noticed that the incision where stitches were removed had dehisced, and the wound looked possibly infected. Here’s that gross pic:
My OS wasn’t in and a different OS who works with him was there and he prescribed me Silvadene cream and Bactrim pills. The plan was to do that for 5 days and then come in to see my OS.
That Monday, 4/17, I went in and the wound did not look any better. If anything it looked worse. After poking and prodding, my OS noticed pus coming out of the tendon!
I was scheduled immediately for a debridement surgery on 4/19, and to see a Plastic Surgeon (PS) on 4/18.
PS told me to expect a worst case scenario of 3 months to fully heal! 3 freakin months!!
I cried a bit that night, but then picked myself up and said I’d attack this head on. Went in for the debridement surgery the next morning on 4/19.
Surgery was successful. Necrotic and infected tissue was removed. The PS was there to monitor what the OS was doing. Thankfully the initial repair wasn’t compromised, and the OS removed 2 sutures they felt were problematic, but assured me the other sutures were in place and not an issue.
Waking up in the recovery room I realized I was attached to a Wound VAC. Great.
They never told me I would need to stay overnight in the hospital before the surgery, otherwise I would have prepared a bit better. After the surgery the OS’s PAs told me 1 night max, maybe 2, while we wait for wound cultures to come back. That turned into 3-4 days, which then turned into the whole weekend with a monday morning discharge. It’s now Tuesday night, 4/25, and still no plan for how to discharge me.
In the meantime, the Infectious Disease Team has gotten results back from the wound cultures, the sensitivity tests, inflammation tests, and 2 different blood tests - aerobic and anaerobic.
The good: no infection in the bone, blood stream, or anywhere else in body
The bad: Staph infection, sensitive type (vs. resistant)
The game plan: 10 days of IV antibiotics (I believe it is Cefaxone) followed by 2-3 weeks of oral antibiotics. (It sounded overkill to me too, but the IDT say they prefer to be over aggressive and ensure I don’t come back in a month with another infection flare up, which is fine by me).
The wound v.a.c dressing would need to be changed 2x a week by a nurse, and 1x a week by the PS.
My specific issue is that I had to be out of my apartment on 4/12, and wouldn’t get into my new apartment until 5/1. My plan was to stay in an Airbnb to ride out the rest of April, and transition to FWB by month’s end just as I get my new apartment. That plan has gone to complete shit.
The insurance I have is a complete joke, despite the fact that we pay quite a bit for it through our company’s group plan. They refuse to allow me to get the nurse for the IV and the nurse for the dressing change near where my mother lives, and instead want to send me to a Sub-Acute Rehab/Nursing Facility. That wouldn’t be so bad if they had a facility in Manhattan, but it looks like the only 1 facility they worked with no longer works with them.
So 7 days after the debridement surgery, I’m still stuck in the hospital which I’m sure is not cheap for the insurance co. We still have no idea what their plan is for me.
On the bright side, the 2nd dressing change showed a much better (relative) looking wound.
This is what it looked like on 4/21 (2 days after debridement):
It was 3.5cm x 2cm
The next day, on 4/22 the machine was beeping that the seal was maybe loose so a doctor who works with my OS, and happened to be in the hospital, came by to change the dressing. I asked him if I could snap another picture and if he could measure it, since it looked better than the day before.
Here it is:
It measured 3cm x 2cm
Either the wound shrunk 0.5cm between dressing change 1 and 2, or the original measurement wasn’t good. I’m hoping it’s the former. The wound v.a.c. also looks to be sucking up significantly less fluid (blood, drainage, whatever) than it did on the first couple of days, which seems like a good sign. There is also a good amount of granulation tissue starting to form which as I’ve learned in the first step towards wound healing and skin being able to grow.
They also put a PICC line in me yesterday thinking I’d be let out, which was pretty sore for the night, but felt a lot better this morning.
I used to look forward to the end of April when I would be cleared for FWB and off crutches. Now, I’m just looking forward to getting out of this hospital, into a shower, and waiting for this damn wound to heal. Crutches, Wound VAC, and PICC line antibiotics, and potentially a nursing facility are in my immediate future.
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Sorry your plans went up in smoke! Glad you’re approaching it with a positive attitude. Sounds like you don’t have to worry about an interim rental now - LOL! And I’m really glad your wound is showing signs of healing. As you know - be your own advocate!
How’s it going?? Hopefully you’re out of the hospital and healing up nicely!