DAY 28 - WEDNESDAY NIGHT

Well, Joe has dozed off and we are awaiting another go-around with the CPM machine at 11:00 P.M. Two hours on and two hours off for 24 hours a day can tire a guy out. Besides, the machine weighs a ton and Joe can't move his own legs, so it takes a few people to get the thing on and off. He seems to be tolerating it just fine on the left leg and the right leg will re-join the rehab on its own CPM machine when the infection is under better control. Yes, we have now added Infectious Diseases to the other Teams that are attending Joe. They joined us yesterday and have become part of our happy little dysfunctional family - Trauma, Orthopedics, Plastics and Infectious Diseases. What's not to love there?
Monday was pretty exhausting as the ortho residents finally realized that the femur incision did not look good. We had been watching the dressing over the incision all weekend with great concern. So Joe was shipped off to surgery on monday to clean and debride the wound. Another 2 liters of infected material, bone chips and muscle fragments were removed and the whole area cleaned. A large pressure dressing was applied and was to stay in place until surgery the next day. Bright and early the next day, Infectious Diseases arrived. They already knew that there was a Staph infection involved and were still examining the material to see if there were any other bacteria involved. As they spoke to us about hoping to save the life and hopefully, the limb, we knew that we were back to our first goal - survival. It was a difficult and frightening time, but we managed to get a grip and prepare for Joe's scheduled surgery for that day... the removal of the external fixator from the left tibia and the bone repair and setting. Now included in this day's surgery was another washing out and debridement of the femur wound and the placement of a nice, large would Vac packed from deep inside to the outside. The plan is to take him to surgery every 48 hours to do the same thing until they feel the infection is under some kind of control. Hopefully, they will be able to keep it away from the bone and give the rod a chance to provide stability until the bone can begin to heal. Dr. S. would really like all the metal out of the body, but that is just not possible right now, so they have to work with what they have. Joe was scheduled to be 4th in line for surgery that day and expected to go about 3:00 or 4:00, and true to hospital form, it was 8:00 when he went. We have learned that hospital schedule change in the blink of an eye, but we have great faith in Dr. L. and he has done an excellent job so far. He has said that as long as Joe can wiggle his toes, he'll keep working on the problems that develop. It helped Joe to be confident about the outcome of the surgery and that gives us some peace of mind. Thank you again for all your thoughts and prayers. Cindi