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Any docs here? Question RE Osteomyelitis

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Any docs here? Question RE Osteomyelitis

Old 06-18-16, 01:24 PM
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Any docs here? Question RE Osteomyelitis

In late December I fell and sustained the worst possible type of left elbow fracture, including dislocation and massive soft tissue damage. On January 5 I had surgery to replace the radial head, pin the elbow into place and repair torn ligaments. I was in a wrist to shoulder cast.

On February 5 they removed the cast and pins. One of the pin sites was infected and the cleaned it out and put me on a round of keflex. Things seemed fine for awhile, I started physical therapy and was progressing. Then in mid March the pin site blew up again. The surgeon lanced it in his office and it drained for almost a week. That started me on four rounds in a row of keflex. The elbow fluctuated some in warmth and swelling, but the warm never went away and neither did the swelling.

The surgeon just kept throwing keflex at it. I saw him in late May and he told me to come back in a month. Soon afterward I started having terrible pain, at first I thought it was a muscle strain. It got so bad that on June 6 I barged into the doc's office and demanded he do something. X rays and a CT scan confirmed massive infection deep in the joint. I spent last weekend in the hospital after they removed the radial head implant. I'm looking at six weeks of IV Telavancin and a summer at 60 percent of my salary on long term disability.

My question is, will this just keep happening? I'm terrified of that. People are telling me to sue the doc, sue the hospital, but I have tried to get second opinions along the way and no ortho doc will even see me! The infectious disease doc had them put the picc line for the antibiotics in my right arm. I can't even reach it with my other arm, which is in a brace 24-7 to keep it from dislocation again. I'm hobbled! I feel angry and helpless and would appreciate any input.
Old 06-18-16, 01:28 PM
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Re: Any docs here? Question RE Osteomyelitis

I had to see wtf that was.... Oh. That kind of shit looks painful.



I'd hate my body for doing that. Infection AND Inflammation of the bone marrow. Yeah. Not for me.
Old 06-18-16, 02:10 PM
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Re: Any docs here? Question RE Osteomyelitis

Damn, that sucks!

Why wont other docs see you?
Old 06-18-16, 02:46 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by wearetheborg View Post
Damn, that sucks!

Why wont other docs see you?
Because I've had surgery in the last year by another doc.
Old 06-18-16, 02:47 PM
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Re: Any docs here? Question RE Osteomyelitis

Osteomyelitis is usually treated quite aggressively once diagnosed. A couple of rounds of oral Keflex (standard fare for run of the mill non MRSA cellulitis [aka skin infection]) hardly seems appropriate. Not that I have to tell you that now.
Old 06-18-16, 02:59 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by TGM View Post
Osteomyelitis is usually treated quite aggressively once diagnosed. A couple of rounds of oral Keflex (standard fare for run of the mill non MRSA cellulitis [aka skin infection]) hardly seems appropriate. Not that I have to tell you that now.
According to the bug doc, the offender here is corynebacteria (sp?)
Old 06-18-16, 03:01 PM
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Re: Any docs here? Question RE Osteomyelitis

PS I have lost over 40 pounds since the fall happened, and still plan on weight loss surgery although not as soon as i'd hoped.
Old 06-18-16, 03:19 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by Vibiana View Post
According to the bug doc, the offender here is corynebacteria (sp?)
IMO, after the first failed round of oral antibiotics (regardless of what it was), there should have been talk about getting IV treatment in conjunction with whatever debridement/drainage that was being done... but then again, hindsight being 20/20.
Old 06-18-16, 03:33 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by Vibiana View Post
Because I've had surgery in the last year by another doc.
So? Are they legally prohibited from seeing you?
Old 06-18-16, 05:53 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by wearetheborg View Post
So? Are they legally prohibited from seeing you?
No they are not. But most surgeons don't want to mess with another doctor's work. First, they all do things a little differently and may not be comfortable trying to address another's surgeon's post-operative complications.
Secondly, sometimes (maybe always, IDK) the insurance won't pay for treating the complications of nosocomial infections. Those are often solely the responsibility of the Doctor and the hospital. So you're unlikely to find another surgeon willing to take on another doctor's potential complications and maybe get bundled into his lawsuit when he probably won't get paid for his work anyways.

I've had a couple of Osteomyelitis patients over the years. It is a royal pain in the ass. Requires a PIC line and weeks of IV antibiotics (with frequent blood draws to monitor drug levels). Not fun.

I don't know much about Ortho so I can't tell you how common that complication is. If you're unhappy and think your complication may be a result of a problem at the hospital my advice would be to call the hospital administration. Let their case managers know about your complications and concerns and they will begin looking into it further. They have to be transparent about all that stuff now.

As far as "Will this keep happening", I doubt it. As you pointed out, this is a deep infection. It takes a long course of powerful antibiotic to clear it. But once cleared, there should be no reason for it to come back. You have a normal immune system and the joint should be sterile.
Old 06-18-16, 06:20 PM
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Re: Any docs here? Question RE Osteomyelitis

Originally Posted by Decker View Post
As far as "Will this keep happening", I doubt it. As you pointed out, this is a deep infection. It takes a long course of powerful antibiotic to clear it. But once cleared, there should be no reason for it to come back. You have a normal immune system and the joint should be sterile.
Thank you. That's a great relief to hear.
Old 06-20-16, 10:52 AM
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Re: Any docs here? Question RE Osteomyelitis

Saw the doc this morning and he took out the staples. He seemed kind of indecisive about whether to, but he did. The incision is still draining, not a huge amount, but seems normal enough. He is going to release me to return to work on August 1, which is a relief because 60 percent of my salary was going to make it pretty rough for the summer. My infusions run through July 26. Apparently he's in no hurry to replace the radial head implant, so I'll be wearing the splint-brace thingie he has me in for the foreseeable future. It's okay, I can type fine with it on, but if he's not going to do the replacement for a while I'm going to just ask him to wait till January when I'll have some leave available again.
Old 06-20-16, 11:51 PM
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Re: Any docs here? Question RE Osteomyelitis

Trust TGM ... According to his avatar he is a doctor and a ninja. Fuck yeah!

Decker just appears to be a stuffy-ass Brit. Albeit, a smart one.

I'm hobbled by a hip injury right now and you are freaking me out Vibiana!
Old 07-11-16, 12:35 PM
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Re: Any docs here? Question RE Osteomyelitis

Two more weeks of the Televancin. I feel vindicated over all the side effects I'm suffering through -- sour stomach, salty/metallic taste in my mouth, nausea, and extreme fatigue -- because I looked it up on webmd.com and the one reviewer said she had never had such an awful time with any medication she'd ever used.

The nausea reminds me of early pregnancy--you can't stand to smell or taste certain things. If I hold an alcohol pad under my nose and get a little high on it, that helps, but not completely. I'm thinking of going on an all-liquid fast, broth and stuff like that, every day after the infusion, because eating just isn't working out, except for in the morning before the infusion and after a night's rest.

Not that I'm not incredibly grateful for the fact that it seems to be working. Three weeks of blood work have all come back normal except for a slightly low hemoglobin and hematocrit. My blood sugar, even without fasting, has ranged from 99-109 which is really good for a type II diabetic. I have lost 48 pounds so far and the next two weeks until I'm finished with the IV infusions I expect to lose several pounds more.

It reminds me of some of my gay male friends back in the day who were on AZT -- the side effects I'm having are very like the ones they had. So glad to have good insurance and an understanding employer.
Old 07-26-16, 10:17 AM
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Re: Any docs here? Question RE Osteomyelitis

Today is the last antibiotic infusion. I'm hoping, since I'm seeing the doctor right after, that they will also remove the pik line so I can come home and have my first shower since June 10. Kansas has been horribly hot the last few weeks and sponge baths are a drag.

All my blood tests have been coming back normal every week, so I'm hoping the infection is gone but I will have to go on oral antibiotics for the next couple of months to make sure of it.
Old 07-26-16, 04:23 PM
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Re: Any docs here? Question RE Osteomyelitis

Sounds good, Vib. Hope it all cleared up nicely.

FYI : It's a PICC line. (A peripherally inserted central catheter)
Old 07-26-16, 05:00 PM
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Re: Any docs here? Question RE Osteomyelitis

It's out! O happy day Also ... another of my medical caregivers (who's not connected to the ortho surgeon or the infectious disease docs) told me today that my ortho surgeon has had a number of complaints filed against him. I sure as hell wish I'd known that in January.

The infectious disease doc told me he's very optimistic that I will have a full recovery. He checked the incision site and pronounced it pretty much healed (there's going to be a truly gnarly scar, though ... )
Old 09-06-16, 11:39 AM
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Re: Any docs here? Question RE Osteomyelitis

Thread bump for an update. I saw a new surgeon last week and he says I don't need more surgery, which is great. I will not have a radial head anymore, and will not regain full mobility or strength in my left arm, but ... it's my left arm.

Annoyingly, my right knee is giving me fits. Seems ironic to lose 55 pounds and THEN my damn knee goes out.

Anyway, I'm hobbling around Kansas City like Lurch from the Addams Family, the happiest gal without a radial head you'll ever see. The bariatric surgery I planned on is off the table till next year, because my employer has already been unbelievably accommodating while I was on disability so I need to keep them happy too.

My old surgeon released me and I got a copy of all my surgical and medical records. At this point I have not decided what to do--pursue any action or not. For right now I'm not, because I want to make sure I get treated by this new doc.

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