My favorite PICC

I think this is how it is supposed to work. Feel sick, get medicine, get better. Both times I've had infections on my right knee, I've treated them antibiotics, and in both cases, the first treatment of the bacteria have failed. As it was four years ago, the second treatment of the infection feels to be working. Finally, today, I feel better than I did yesterday. And yesterday I felt better than the day before. I'm finding wood to knock on, but I do believe that tomorrow I shall feel even better than I do today. I'm actually scheduled to go home tomorrow . . . . sometime.

So why is the second-time around so different? Well, the doctors are treating it more aggressively. As my infectious disease doctor said, she's treating my infection now like it's osteomyelitis. When I go home tomorrow, I will have an infusion company deliver the same powerful antibiotics I have been getting here in the hospital: Vancomycin and Zyvox. To administer these medicines, I had my PICC line inserted this morning, my third in my lifetime. Twice a day for each medicine, I'll have to connect a pressurized ball containing the medicine to the catheter in my arm. Over a period of about an hour for each dose, the medicine will trickle directly into the superior vena cava in my heart. Sounds pretty cool, huh? Regular IVs would "blow out" or become scarred (not unlike my knee) if they are used for extended periods of time. By trickling the medicine directly into my hear where it can immediately be distributed, the line can be left in place for long periods of time, possibly 6 weeks in my case.

Of all the monotony and routine boardem at the hospital, I have to say the the 40 minute procedure to have my PICC line installed was thrilling! Not only were the nurses so very friendly, one of whom was kin to me, but they were playing classic rock, just as I remembered from 4 years ago. The radiologist doing the procedure was impressed that I remembered him from 4 years ago, but I assured him that I it's not easy to forget a cool, layed-back professional who stuck a tube into your heart while we sang Van Morrison songs together. And just like the first time, we sang songs and played "name the tune and band" the whole time. I won. I was actually a little sad that the procedure didn't last longer and that I'd have to return to the white, stale, monotony of my room. At least my wife would be there waiting.

Back in the room, watching the latest Sportscenter on ESPN, I heard that New England Patriots' quarterback Tom Brady, who underwent ACL replacement surgery 10 days ago after a season-ending surgery, had to go back into surgery this past Wednesday because of an INFECTION!!!! If that news alone didn't make me feel better, to know that even the best quarterback in professional football who is getting, no doubt, the best care in the world, suffered the same unexplicable, painful affliction, I soon got more consolation news. It turns out that Payton Manning, the Colts QB, the OTHER best quarterback in the NFL who had knee surgery this summer, admitted to having another surgery just 4 weeks before training camp because HE too had an INFECTION!!! Wow! Now Tom, Payton, and I have more in common than just playing quarterback for our middle school football teams . . . . we're all three quarterbacks (or former quarterbacks) who have had post-op knee infections. Of course, I still have one up on them in that I had two to their one.

Anyway, I'm very excited about the Texas vs. Missouri game tomorrow night. I'm even more excited about watching in from the comfort, yes COMFORT, from my own living room, just me, my wife, my kids, the TV, and my PICC line. I'll be sitting by the phone just in case Tom Brady wants to call and ask for advice. I'll be sure to mention the "shampoo cap."

Feeling good and clean

It's lunchtime in room 215 at Christus Santa Rosa Hospital, although I don't feel much like eating.

Last night, the surgery went well. The surgeons cleaned out my knee more aggressively than ever before, removing any tissue they deemed might be remotely infected. As I awoke from the surgery, my pain was very different from the throbbing, constant pain caused by the swelling. Instead, I felt like my knee had been ripped apart. I could feel their aggressiveness via the stabbing pain, but I was glad to have, at least, a new kind of pain, one that would hopefully be temporary.

The doctor ordered some super sweet medication to help me sleep through the night, and except for being awoken for my regular doses of Vicodin, vital signs, and labs, I slept soundly and deeply for the first time in 5 days. Waking up this morning, the stabbing pain from the night before was gone. In fact, I didn't feel much pain at all. Was I dreaming? My dad soon arrived with some magazines, and I realized that I was really awake. He called in my breakfast to room service, a breakfast taco, a banana, and "the largest black coffee you can find." Sitting in the room eating breakfast talking to my dad, it ALMOST felt like he and I were sipping coffee in a coffee house, a coffee house with an IV pole.

In short, it was a good morning. I feel good for the first time in a long time. All my doctors have come by and talked to me, essentially saying the same thing: we don't know why this happened again, it's never happened before, we're going to put our heads together and try to figure out what to do, . . . . . My day has been relatively good so far, broken up by visits from the physical therapy woman who has been forcing me to straighten and bend my leg--very painful, but very necessary.

I even had the housekeeper come in and do an Extreme Makeover, changing the linens and sheets on my bed, emptying trash, mopping the floor, all while Shealynn helped me sponge bathe in the chair next to the bed. Before today, I never knew there was a "Shampoo plus Conditioner Cap," a warm cap filled with lather that you put on, then massage all over you head. After waiting a few minutes for the unscented conditioner to do its softening magic, you simply remove the cap, and towel dry your head.

It's not Pert Plus under a cascade of hot water, but it does have a psychological benefit of helping me "feel" clean. As of right now, it looks like I might get a chance to shower cap it through Saturday, trying to get home by Sunday and back to school by Monday.

The Results of the Aspiration . . . .

It's YELLOW!!! I'm sitting at the hospital going through the admitting process. The surgical team in the OR is already waiting for me. The infection is back, or it never went away. That would explain all the pain I've been having.

I'll be out from school the rest of the week, and with my tenacity and stubbornness, I'll be back on Monday. The last time I had an infection, the third one was the charm. I hope it is again.

Can you tell how well I'm masking my frustration and anguish?

As Pat Buchanan said to his military draft board, "Bad knee, gotta run."

Aspirations of Red

Something's not right. Each day, although my knee is not getting worse, it's not getting better. The last two days, I've been back at work, sitting like I should, keeping my leg elevated like I should, taking my antibiotics like I should, but my knee has increased in its swelling during this time. The pain hasn't gotten worse, as in "intolerable, excruciating" pain but it has been at a sustainable "distressing, constant throbbing with occasional piercing" pain. Because of the swelling, which I HOPE is not from the bacteria restating its claim, my flexibility and mobility are severely reduced. Being an independent, aggressively physical, active type of guy, I feel like such a gimp inching around on my crutches. Throw in the character flaw of impatience, and you can understand why my situation is has now escalated well beyond "frustrated." I'm beginning to get downright angry.

If only I wasn't so tired, I might let out a mighty roar. Staying positive, going to work, smiling through the pain and discomfort, all requires strength and energy, strength I do not have and energy I am rapidly running out of. At some point, you would think that my bad luck with these "routine" surgeries will run out and that "law of averages" would prevail. Getting another improbable infection from a standard arthroscopic procedure is horrible luck, but additional complications during a standard treatment of a staph infection of a joint goes beyond bad luck. It's as if Providence is administering my punishment for me being such an awful guy . . . . oh wait. I'm NOT an awful guy. In fact, I think I'm a pretty nice, upright guy. So why all the unfairness? I can't answer that.

What I DO know, is that as bad off and unlucky I seem to be, there are people in this world in worse situations than I who are, perhaps, even more undeserving of their plight. If you want to see the people I'm talking about, just tune into Discovery Health Channel sometime, or watch "Trauma: Life in the E.R." There you'll find a man known as "the human tree," a man whose warts are so bad, and cover so much of his body, that he looks like walking bark. Then there was that guy in the E.R., a lumberjack, who fell off some machinery and had his leg partially severed. Yeah, those things actually make me feel pretty good. By focusing on the things that are good about this whole situation, like having a wonderfully supportive wife and understanding, helpful children, realizing how valuable I am at school to my students, and . . . . . . nothing else.

With so many others out there who would do anything just to be in my condition, like Tony Romo and his injured pinkie finger, it helps me get through my own misfortune, and reminds me that even though misfortune never does (miss), pain and fortune is all relative. I've just got to remove my blinders and enlarge my outlook. Easier said than done, though, especially as I lay in the dark each night for hours and hours on end grumbling and moaning shifting positions desperate to get comfortable. It is THEN that I think of that guy somewhere on this planet who has no eyelids who sleeps on his back on a bed of nails with a bright halogen lamp beaming down on him from above. Although it doesn't help me sleep, it make me appreciate the fact that at least I'm lying awake in the DARK.

Sleeping tonight will be a very arduous task once again. With doctor's permission, I'm going to try a pain killer/Benedryl cocktail to see if that won't help me to doze off. Additionally, I've got an emergency appointment scheduled with my surgeon tomorrow to aspirate the inflamed knee. Hopefully this will not only relieve the pressure caused by the swelling, but hopefully the fluid comes out red and not yellow. Red means "blood not yet draining from surgery, it should heal fine on its own not and I'll be able to sleep at night," while yellow means "infection is back and another surgery is immediately required to irrigate the site again, and I'll have to miss more school and/or spend more time in the hospital."

Who would ever have know that I'd be praying for blood. In what other context is Red so supremely superior to Yellow? Although that's a rhetorical question, I will have plenty of time tonight as I try to sleep to formulate an answer to that (in between moans and prayers for red, of course.)