Monday, September 16, 2013

Doctor Doctor...

It is beyond crazy to me that we are already 16 days into September. It feels like we didn't even have a summer. That may be in part due to the fact our summer was kinda shot to pieces when Chris had surgery to remove hardware from his elbow in June which turned into months of doctors visits, medication and hospital stays. It was a tough summer for us. Let me back up.

Chris has broken both of his elbows. One he broke in 2001 playing roller hockey with his brother, the other playing softball in 2003. Both required surgery and hardware. In 2003 he had surgery to remove the hardware from the first elbow. The hardware in his second elbow was not removed till recently. People have all sorts of pins and screws in their bodies for various reasons. It is generally harmless and in some cases necessary. Chris was told unless it bothered him he could just leave it in. So he did. It didn't bother him and up until about a year ago we had no reason to think he should have it removed.

He started developing this bump near his elbow. It didn't hurt and wasn't red or anything so we weren't overly concerned. It did however creep me out (it was so obvious I named it Carl) and I nagged him to have to have it check out. Finally he got tired of my nagging and he went to see his doctor. A diagnosis of a ganglion cyst was made. Totally harmless. A few weeks later Chris developed a red bump on it that looked like an ingrown hair. Again he went back to the doctor. His doctor then decided to lance the top part. When he did this he must have poked the whole thing because for the next month that darn thing continued to leak stuff from it. Gross yes, but that's what was happening. He had to keep it bandaged at all times and it was not healing. Back to the doctor he went and the decision was made to send him to the orthopedic surgeon and have them decide what they wanted to do with the cyst because of the hardware that was also in his arm. The decision was made that because they had to go in and clean the cyst out anyways they would remove the hardware as well because they didn't know if the cyst was a result of the hardware or not. Easy enough right? One surgery to take care of both things. A couple weeks recovery for his elbow to feel 100% and all is good. Ha! If only.

Surgery went fine. One of the screws was actually so grown into his bone it broke off. The surgeon broke 5 instruments trying to get it out. Ha! During surgery they took a shaving of his bone to test it to make sure it wasn't the source of the cyst/infection in his elbow. Sure enough a few days later Infectious Disease called to let him know that the sample of bone did in fact come back positive for infection. Sigh! Off to the Infectious disease doctor we went. Treatment for a bone infection - 6 weeks potent IV antibiotics via PICC line so he can do it at home, followed by 4 months of oral antibiotics.


The PICC line scared and creeped me out from the beginning. They insert it through your upper arm and the small tubing is moved through a vein and comes to a rest just above the heart. This is the best location for a big vein to shoot the medication straight into your system. However PICC lines need to be kept VERY sterile and dry. Any bacteria would go straight into your vein and then you could be in trouble with a blood infection or worse, an infection of the heart. I was the one to administer the meds so I was constantly nervous I would do something wrong and make him sick. 

He started his IV meds on June 26th. It was easy enough. One dose in the evening that took about 5 minutes to push through via syringe. All was going good till the the morning of Sunday July 7th. The night before Chris had been complaining about feeling really tired and a little on the hot side. One of the main things they warned him about in regards to his PICC line is a fever. He took his temp and it was 99.2. Which really isn't an issue except with Chris he runs cold, usually right around 98.0. Anyways he decided to go to bed and see how he felt in the morning. Sure enough he woke me about 7 am with a 100.5 fever. He had already called his doctors and they advised him to go to the ER at OHSU. So off we went. The ER doc immediately started running all sorts of tests. Chest x-ray, urine sample, blood work and cultures. As the clock started to tick toward the afternoon his temperature was going down and all his tests were coming back normal. However his heart rate was elevated because of the fever and the doctor was not comfortable sending him home. It was determined the PICC line was not infected and they would keep him overnight to monitor his temp and his heart rate.  By early evening he was feeling much better. Vitals were normal and his temp was right back to where it should be. I left the hospital at 9pm not long after they gave him his dose of his medication. By 11 pm he called me to tell me his fever had spiked again and was 102.5. By morning it was gone. They once again became concerned the PICC line could be an issue so they decided to pull it out. 

All day Monday he felt fine, no fever etc. He did not have his regular dose of the medication he was on that day because the PICC line was out. They had just given a broader spectrum antibiotic while waiting for the blood cultures to come back. By Tuesday morning he still had no fever and the decision was made that they would put the PICC line back in and he would be discharged later that day. In went the PICC line and in went his dose of meds. Sure enough within minutes of the dose stopping he started feeling really crappy and his blood pressure was spiking etc. Needless to say he was not discharged that day and by 8pm his temp was back up to 103. By Wednesday the doctors had all but decided the meds were what he was reacting too and decided to stop switch his meds and keep him one more night to monitor him. Sure enough without that specific drug all day Wednesday and Thursday he had no fever. He was discharged and we were sent home Thursday afternoon.

Thursday evening we had a nurse visit and bring us his new meds.This one was a little more annoying and took 2 hours to administer. It came with a little pump that pushed it for you.
After a few days they had to up his dose because his body was flushing it too quickly. Sure enough after that he started feeling under the weather again and his temp was slightly elevated. The decision was made not to put him through anymore crap and the PICC line was removed and they switched him to just oral antibiotics. So all has been going great since the switch to oral. His elbow looks to be healing really nicely. He has about 6 weeks left of antibiotics to go. Finally in the home stretch.

While his hospital stay sucked and was scary we were blessed with a beautiful view and sunny weather out on the balconies. Silver lining.



1 comment:

Victory said...

Seems like buy yesterday. But glad he's back on the up and up!