So, I had the dreaded appointment with Infectious Diseases yesterday. Unfortunately, it was basically inconclusive since he was missing the findings from my clean/debribe surgery AND my last lab test results. So, mostly, he checked it out, we discussed the history of things thus far, and then discussed possible scenarios.
Basically, this can go one of three ways from best to worst case scenarios.
Best case: It's just a sub-cutaneous infection, and hasn't actually involved the hardware or bone, in which case we will continue with oral antibiotics and monitor things.
Mid-case: The hardware is involved and there is biofilm over it. This can go a few ways depending on the orthopedic standpoint and outlook. If the hardware needs to stay in, then it's 6 weeks of IV antibiotics followed by another 6 weeks of oral antibiotics. If the hardware can be removed, that removes the danger (and the inaccessible by your body bacteria) and treatment would be easier.
Worst case scenario: The bone has become infected. If that is the case, we are in dangerous territory. Removing hardware ASAP is important, but no matter what it will be intensive IV followed by oral antibiotics. This is where people lose legs, and things get really scary.
Since my ortho left the hardware in, AND I haven't gotten a call to schedule another surgery, I'm HOPING the last case is definitely not the case - but I can't confirm that yet. There are a few (small) things in my favor - one, this hasn't been festering in there for long. Some people go years without a conclusive diagnosis, and by then the infection has so well embedded itself that eradication is often only attainable by amputation or invasive and continual surgeries and treatments. At least this manifested early and my body reacted, and we knew what we were dealing with....even if it's been latent in there since my last ORIF, it's still 'only' been a matter of 4 months instead of years.
Secondly, it's not MRSA. While the bacteria in there is NOT a good one to be fighting due to it's ability to quickly mutate (enterobacter cloacae), making it harder to treat, it seems like it's at least a better situation than dealing with a MRSA infection. Not much better, but slightly as there are a number of treatment options that seem to be successful depending on the strain.
Third, my doctors are on this like flies on shit. They aren't wasting time, they aren't being lax, and they are treating it quickly and decisively rather than dragging their feet or being unconcerned like a lot of people online seem to report.
Of course, for me, my mental state is getting a bit - edgy. I'm holding it together (most of the time) but I feel myself on that edge. Thankfully I can still ride, which is keeping me sane (literally). I asked the ID doc about riding with a PICC, and as far as he's concerned, if I'm cleared by the orthopedist to ride, there are no restrictions or limitations with the PICC line. That makes the process more bear-able for me. It will still be a nightmare, and the "inconvenience" is going to be horrible, but maybe I can at least retain my sanity...
Part of me, however, is of the opinion to just pull the hardware at the end of the month and be done with, and quite playing games with infections. I realize I'd be laid up again, but that would be 5 full months of healing behind me, and I would think that it shouldn't be more than a few weeks of being laid up...granted, I'm no doctor, but that's my gut feeling on it.
So, things are still very much up in the air and I'm still in no-man's land of what is going on. I meet with my ortho tomorrow, so I plan to discuss options on that end of things so I can start putting things together in my own mind. I don't want to play games with this, racing, my trip to Italy, NONE of that is worth potentially losing a leg over, but that being said, on the flip side, if there's not a lot of danger, then it's nice to have some semblance of a life, too. Guess I'll find out more next week when I meet with the ID doc again.
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