Thursday, May 19, 2011

My MRSA Story, Part One.

For a long time now, I've been promising many people that I would write about how my MRSA infection came about, so I am going to attempt to do so, before some of my memories start to dissipate into the haze of summertime, should it ever choose to arrive.

Very briefly, for those of you wondering, what is MRSA?  MRSA is an acronym for methicillin-resistant staph aureus and is a type of bacterium often found on the skin and in the nose of healthy children and adults. Quite simply, it is a type of staph that is resistant to the penicillin-related antibiotics.

Lately, I've been doing a lot of research about MRSA and I find the more I look into it, the more questions I have, and the more angry I become at how little information is truly out there about this debilitating "superbug".  It is truly a shame because more Americans die every year from invasive MRSA infections than from HIV/AIDS or H1N1 flu. What's more, 85% of all invasive MRSA infections were from healthcare facilities with patients contracting infections after their stay ( two-thirds) and one-third while in the facility. 14% of all infections occurred in the community with no exposure to healthcare and this number is continuing to grow. All of this data is from 2005, and it is well known that the numbers have skyrocketed since that time. It is also thought that the lack of regulation on the healthcare industry to report MRSA statistics has kept the reported numbers artificially low.

I am not sharing any of this to scare you or cause you to walk around with masks.  The fact is, MRSA is so prevalent, it is likely you come in contact with it on a regular basis, but some very basic knowledge of MRSA can prevent you from having it affect your life in any major way.  I intend to post more about this in coming posts, but for now...my story.

On December 7th, 2010, with the help of our midwife/ARNP and our doula, Roger and I gave birth to our third child, a girl who we named Ada.  It had been quite a night--labor beginning late evening, calling our midwife and doula so we could all make it on the last ferry to the mainland for the night, arranging for grandparents to come from a different island to be with our two sons, Gunnar and Finn.  My labor went much more quickly than my last two births, which had been with the same midwife and in the same hospital.  I spent a good deal of time in the bathtub, especially when the pain really descended on my body.  Before too long, I was at 9 centimeters.  Unfortunately, I stayed there for hours.  Finally, I decided on an epidural, and within a very short time, my labor had progressed and I was able to push my baby girl out into this world.  It was such a beautiful and sweet moment, her arrival. Her brothers were elated, as were the rest of our family and friends who came to see Ada.  Since we were now "veteran parents" the nurses mostly left the three of us alone, and the next afternoon we were on a ferry back to our island.   

The next few weeks were an adjustment, to be sure, but I found myself increasingly surprised at how much easier it was compared to my expectations prior to Ada's birth.  I went out hiking with all three children.  I was able to rest a fair bit.  Ada was a surprisingly good sleeper and a very mellow baby.  I had a checkup with my midwife. She told me I should take it easy, relax more.  Somewhere during this time, I noticed a pimple underneath my left arm.  I didn't think much of it because, even at age 35, I still get acne from time to time.  It became rather painful, but again, I didn't think it was anything to worry about, and I treated it myself by squeezing it and draining it in the shower.

On December 22nd, I stayed up late to prepare for Christmas, as we were going to travel to the island where our parents live.  I sat on the floor for a few hours, wrapping presents.  When I got up, I felt intense pain in my right hip/thigh, and had to limp back to bed. I didn't think much of this either as I had had some hip pain and tenderness during my pregnancy, not to mention a very painful birth.

The next night, we stayed at my in-laws' house and for some reason, Ada was fussing all night.  I was not able to walk her, so my dear, sweet Gunnar got up and walked her for me.  I cried most of the night.  On Christmas Eve morning, we went to the on-call doctor at the local clinic.  The PA who saw me was very nice, and spent a lot of time with us.  Her diagnosis was bursitis of the hip. She gave me what she described as a "very powerful anti-inflammatory shot" in my arm, and said I should feel its effects within several minutes.  While she looked for a pain killer that I could take while nursing, I waited to feel some relief.  It never came.  What's more, the PA said I should probably refrain from nursing for the next few days while I took the pain killers.  This made us a bit frantic as we had to find a breast pump and feed our new baby formula.  Thankfully, our good friends with three little ladies served us up a very deluxe pump pronto, and Ada seemed to take to the formula for the most part.

Christmas night saw us back at the local clinic with another on-call doctor.  He took my temperature, which was slightly elevated, but not alarmingly so.  He looked for signs of a neurological problem.  He seemed to concur with the diagnosis of bursitis. I believe he also gave me an anti-inflammatory shot and some heavier pain medication.

Nothing touched the pain, though I continued to take the medication.  I had to hold on to the walls in order to walk.  I did more research on the pain medication I was taking and felt safe to go back to nursing Ada.  I spent every  minute of the day and the next few nights sleeping in my father-in-law's motorized recliner as it was the only place I could sit or sleep without excruciating pain.

We went back to our island, as Roger had to go back to work.  Sleep did not come easy.  Nothing did.  The pain continued.  This part of the timeline is really a blur to me.  On December 28th, I saw a doctor on our island.  He went through most of the same motions as the previous two doctors.  He took my temperature, looking for an infection.  I'm not sure which doctor told me to increase my dosage of ibuprofen a sizable amount (I think the second one), but I know now that it was probably masking my temperature and later sent me into preliminary organ failure.  This doctor decided to give me a cortisone shot  in my hip.  I was so hopeful that this would finally take the pain away, but no such luck.

By New Year's Eve, I was in yet another on-call doctor's office in the middle of the night.  I remember almost nothing of this visit, but I know by this time my hip and part of my buttocks were very swollen, tight and red.  This doctor had nothing else to offer me, other than to say I could go to the hospital in the morning if I felt I was in too much pain.

I had had enough of being in pain, no sleep and taking care of three children.  Thankfully, family had come to help, but the pain was agonizing.  So, on New Year's Day, with Ada in tow, my mom took me to the ER at the same hospital where I gave birth to Ada only a few weeks before.  Again, the details are fuzzy in my memory, but I do remember that the ER doctor and his nurse were rather sarcastic in their responses to my situation. The doctor basically said I could go home and take more pain meds, or check myself in for observation.  This wasn't even a question for me,  so my mom went home, and Roger caught the next ferry over to be with me. I had no clue of the horror that was to come, nor that this would be day one of over a month I would spend living in the hospital, most of it without my new baby.

More later...

Wednesday, March 9, 2011

Meanwhile, back at the Ranch...

I know. It's been a loooong time since my last post. Since I've been home there just hasn't been the same amount of time to reflect, to pour out my thoughts via typing on a computer. And, to tell you the truth it's been quite an adjustment. More on that later.

I got out of the hospital on February 1st. Roger's uncle, Colin was there to escort me to the door and my Aunt Nia was there to whisk me home. I arrived Orcas in the early evening, and upon pulling into the driveway of our little house in the woods, I could see my little family waiting for me in the window. I couldn't take it. The tears came flowing forth. I got out of the car and was in full ugly cry before I hit the front door. There were so many thoughts, so much emotion flooding my mind and heart. It hit me so hard how lucky I was to be coming home, that had things been different I might not have returned home at all. Or that I might have returned with only one of my legs. At one time not so long before, these were slight but very real possibilities. Thank God neither of these came to pass. So, I hope you can imagine what it was like for me to go inside my house and kiss my honey and my babes and my mom and dad. I will always remember that day and how it felt to embrace all that without taking even one little bit of it for granted.

Fast forward to today. I am healing well. I am told that I am healing better than the average Joe, and for that I am truly grateful, but the whiny little kid part of me keeps asking, "are we there yet?" I have family and friends who sacrifice and come from far and wide to make sure I have some help almost every day (insert applause here). I have a home health nurse that comes from Friday Harbor four mornings per week to do my wound care. She is a most wonderful woman and I'm going to step out on a limb here and say she has become my friend as well as my nurse. I no longer have the wound vacuum, and am back to traditional wet gauze dressing that has to be changed twice per day. Fortunately, it rarely hurts except for the occasional stubborn tape debacle, and my oh-so-sainted husband has taken over my wound care every night and all weekend long. Yep, we get to play doctor.

My wound is the shape of a samurai sword and goes from my hip to just above my knee on the outside of my right leg. The lateral part of the sword's handles are healed together into purple scars. The vertical part, or the bottom of the sword is completely filled in with tissue and is just this week beginning to scar up as well. The blade of the sword, while considerably smaller than it once was, is still open and has a bit of depth to it, though it too is filling in. Mind you, I know all this by looking at a photograph, not by actual sight. My surgeon says I need to make friends with my wound, but I haven't quite gotten there yet. Go figure.

I've been back to Harborview for three checkups and have had a few setbacks in the form of little tracts in my wound. I won't go in to explaining exactly what these are, but to say they are little voids that get healed over by new tissue, and when you close up a wound, you don't want any voids, as they can lead to infection. I am told they are quite normal during the healing process, but again, insert whiny little kid here.

And here for that matter, where I tell you that even though I know exactly how lucky I am, and that I have great days when I feel as if I am almost normal again, I also experience some low points. I can't help feeling guilty about these times because, quite simply, I'M ALIVE. And I'm not in the hospital anymore. Period. But still. There are parts of being home and feelings that I never anticipated. It's kind of a funk, really, and there are many reasons for it. I get tired very easily, and though I am so very grateful to have a friend or family member to help every day, sometimes that can be hard too--to be "on" all the time. I feel as if I have all these things to do, but am not doing any of them very well at all. I am a bit cooped up as I am in my house a LOT. Up until recently I wasn't driving at all. My wound care takes up a good few hours of my mornings, so that cancels out going to any playgroups or activities I could do with the little babes to help me get to know my new community more. By the time Roger does my wound care at night we are both just shot. Plus, we are new to the crazy Club Havingthreekids and aren't going at it with our normal stores of health, energy and time. Then there are the medications. I won't even go into that other than to say I am looking forward to the day when I can put my weekly pill organizer away. Oh--and some advice--don't forget to take your meds. No es bueno. There's more where all this came from, but whiny little kid needs to stop. Seriously. Alive. Health. Home. Family. I have these, and these are all I need right now to get me to the other side of this thing.

As I type this in my bed, I hear the soft, rhythmic breathing of my husband and my 3-month-old baby girl. Upstairs are my boys in their respective beds. Each time I stop and acknowledge this very basic but beautiful reality, I am truly happy. Sometimes I take it further--the truly amazing natural world that lies just outside my door, and then to you--my family and friends. My People. You continue to surround me with your thoughts, your love, through whatever means you have chosen, be it direct or indirect. As I have said before, you are helping me to heal. Thank you, thank you, thank you.

P.S. Thanks for bearing with my Whine-a-thon. xoxo

Tuesday, February 1, 2011

What's happening 'round here

So the news is out, and it is true indeed: I get to go home. Today. My heart beats faster just to type this information. On the other hand, there is a part of me that remains reserved. Until it's a done deal. Things around here seem to change on a whim and so frequently. But it does seem highly likely and I am behaving as such.

This all came as a surprise at first. Nurse Fran, the wound vac nurse with years of experience, the one who constantly advocates for me with the docs, changed my vac on Wednesday, while my Dad was here. About 20 minutes after the change, she whisked back in to my room, her face flushed with ideas and possibilities. After seeing the vast progress of my wound, she decided there was very good reason for me to go home. With a plan. The plan part is most important, she says.

Fast forward through a few days, lots of minor stories and back and forth conversations, and here is where we stand: There is a home health nurse who will come to my house on Orcas to change my wound vac several times per week. Her first visit will be Wednesday! Harborview is having a few of my family members and friends get trained on changing the wound vac (don't worry--just as assistants to the nurses) because the primary nurse will need an extra set of hands when I'm at home.

On Friday, my wound vac was changed by of my very favorite nurses here, Anna, with the assistance of my dad. Anna is only 22. What's more is that she has only been a nurse for 5 months. That's it--Nurse Anna and my dad. They were the best team yet. Anna did such a perfect job, and she did it quickly. This is monumental when one is dealing with pain. She said in all seriousness that my dad should b a scrub nurse...go dad!

My Aunt Nia and bestie Erin did it yesterday with Nurse Fran. They were absolutely amazing too, but a recent change in my pain meds made it one of the most painful sessions indeed. Luckily I had my Erin to cry with me. And a tootsie pop. Those are my new coping tools--lollipops. Lollipops and this lovely iPad my other bestie, Amanda, let me borrow.

So now, I wait. I wait for all the powers-that-be to pull all the strings necessary for me to blow this pop stand. Cannot wait to hit that freeway, then the ferry landing, then the islands, and finally...home. I've got quite a family waiting for me. It's going to be a whole new chapter, being at home. I still have much in front of me to heal this body of mine. So, I think I may be writing this blog a while longer.

I am finally at a point in all this that I can ruminate on what I have learned and am learning from this experience. I am thinking of other things that have come as a result of it, reasons to be grateful for it (not an easy one, but I'm trying). And still, there is my little ball of anger that creeps in now and then asking, why? Over and over--why? But it never stays long, because I have had the most devoted family and friends to prop me up, to keep me from falling into the abyss, so to speak. There are also the quiet moments, when I just breathe, and feel my Self fall away. That's when I can feel the other voice. The voice that speaks without speaking. This voice is only truth, and love, and balance. I will be writing more about these things--what i have learned and my people--after I return home. There is so much to be said.

But right now I need my husband, my babes. My island home. My bed. Fresh air. Daylight on my skin. Real food. Sleep free from interruption. Normalcy, or something resembling normalcy. Thank you for your prayers, your thoughts, your love. As I have said they are oh so needed, and truly will continue to be so. Though I have made it through the worst part, I have a long road ahead of me, so if you still feel like it, prayer is much appreciated.

So, for now, over and out. I will write again soon, after I get settled in at home. Home. Sure feels good to say that word. Love to all of you. xoxo

,

Tuesday, January 25, 2011

Roger flies the coop

Roger went home today. Actually, Roger and Sharon brought the boys down to surprise me as it was Gunnar's 12th birthday (that deserves it's own post). Once again, it refueled me to see those two, to hold them in my arms.

Especially because today was a wound vac change day. Roger stuck around to be with me through that. The nurses told him he should be a nurse or surgeon, as he anticipates even the things they need. I was extremely on edge today about the vac change because they had to remove my pic line (the line through which they give me IV meds), as they were trying to prevent any possible source of reinfection, which is good. However, I had to make the decision before the procedure whether I wanted them to dig around trying to install a new IV line just in case I couldn't make it through, or just leave it be and go into it all with only oral meds. I chose not to reinstall the IV and my nurses and Roger are rock stars that got me through it all with only oral meds and minimal pain. This is huge and wonderful for my recovery. Plus, my wound is looking fabulous, lots of granulation, lots of shrinkage. So many reasons to celebrate today.

Except that my honey left. Notice the hour I am writing this and that I cannot sleep.

Don't get me wrong. It actually brings me great comfort to know that he has gathered all our babies up and will be in our Orcas house tomorrow night. Boppa and Grandma Sha took the boys back to Friday Harbor after their visit. Roger waited with me after the wound vac for my Uncle Wolfie and Aunt Luz to bring Ada to us. She finally arrived and my heart was beating so fast when I saw her. I cannot explain the elation that floods through me when I get to hold that little girl. I laughed, too, because Uncle Wolfie likes to spike her little crazy mane of hair so she looks like a rocker. When it came time for Roger to take Ada to Friday Harbor, Wolfie said he held back tears, and Luz said it would be so sad to go back home without Ada there. I am so blessed that she was in their care. I think they will remain uniquely special people in Ada's life for a long time to come.

Back to Roger's departure. I am okay. I have had some time today to reflect on these past three weeks in the hospital with him. This may sound very strange, but I feel so lucky in many ways for this time with Roger, for the ways in which we connected. All the unimportant things in our life just fell away. What was left was his active love. His loyalty. His eyes locked on mine in the middle of what seemed like impending doom and catastrophe. His hands holding mine, keeping me grounded. Keeping me safe. He has seen me at my very worst, in the most undignified of positions, and still he looks at me with love in his eyes. There is no "date night", no carefully planned romantic interlude that can reproduce the intense feelings of love that have bonded us together so closely during these past weeks. To use only a few cliches, Roger is truly my rock, my hero. He will tell you himself he is not an overly patient person, but he mustered all the patience he could find and gave that to me, sat here in this boring hospital, day after day. For nearly a week he had only lineman boots to wear!

And tomorrow, he will take care of our babes in our home. I have loved watching him with them. He is having to take over so much of the care that I normally do for them, especially with Ada, and I believe this is another gift to come of this awfulness. During wound care, I compulsively spat out reminders for being Mr. Mom--"make sure Finn brushes teeth in the morning too" or "make sure you burp Ada in the middle of her feeding". But the truth is, he doesn't need my incessant reminders. He shines in a crisis, and he always has. My children are so lucky to have him as a father, and I am speechless when I think of how lucky they are to see the the way their daddy treats their mommy. I think of the beginning of this mess, when everything was in question, and no one could tell us whether I would even be okay. This was horrific, and though he tried to be strong, I could tell Roger was terrified. There was a time when he couldn't hold it in, and he took one look at me and took hold of me as he burst into huge shudders of tears. This is what it is to be loved. Thank you, God for this most amazing man. I would not be here, on my way to rapid healing, without him.

That said, I miss him. A lot! I keep looking for that curled up ball of a man on the little chair next to my bed. Hopefully he is cuddled up with baby Ada, or Finn. Hopefully rest will come to him. He definitely needs it. So, if you happen to see Mr. Roger A. Sandwith (not Roger B.--the big one) please tell him his wife is in awe of him, and give him a hug. Don't worry, I won't make you give his cute buns a squeeze! Sorry--TMI.

Hope all of you are well, that you have someone you love to snuggle up with on these dark rainy nights. See you soon.

xoxo
Marls

Saturday, January 22, 2011

All shall be well

From the outside, hospital life appears rather uneventful, now that all the major catastrophes have simmered down, yet there are big changes, every day. Each day I wake with a new attitude, a new outlook on our life--bad, good and everything in between. Each visitor, each phone conversation is monumental to me, and I like this--that time doesn't allow me to take anything for granted right now.

This morning the White Coat Brigade came in as usual around the 5am hour. One of them said if I could handle my 10am wound vac change without IV meds, I could go home as early as tonight or tomorrow. This got us all wound up, as I believe yesterday was the first day Roger began to lose patience with being here.

He had gone to get Ada for a while to have a little spot on her leg checked out (don't worry--everything is a-ok),and when he returned he said it really irked him that we weren't taking care of her ourselves. It's definitely a hard thing, and one I, too try to keep out of my mind because I know she is being cared for by the most amazing people, and it's necessary because I need very much to get well.

Then wound vac change time came. This time three nurses did it, which is the norm here. Nurse Fran is awesome, and she's been doing the wound vac for over 20 years. She and the other nurses did so many things to anticipate my pain and any discomfort, to make it as positive experience as possible. I laid on my side, holding Roger's hand, looking in his eyes and breathing, breathing. All the while held my baby girl's little face in my mind, praying that I could make it through without the IV meds.

But the pain came in waves too sharp for my breath, too sharp for my sweet girl's sweet little face. Then the flood of tears. And disappointment. "I'm sorry, I'm sorry," I said to Roger, to the nurses. They all reassured me over and over, and that made my next goal just to get through the procedure. The good news? Nurse Fran was blown away by the amount of healing that has taken place. She said it is going way faster than she ever thought it would.


They even took measurements to keep track. Here they are for those of you medical enthusiasts who like that king of stuff:
44x13 cm
27 cm crosshatch
Full depth (yech!) 9 cm at deepest point

Plastics even came to take a look again, and again, they said I may not need a graft to close it up, or it may be minimal.

More to the point--I'm not coming home tonight. Or tomorrow. Or anytime relatively soon. Nurse Fran gave me the patience speech again. And I know she's right. She says I'm healing so fast that I may only need to give it a week or two and it's possible I could go home with the wound CLOSED UP, meaning with no more wound vac. Meaning no thrice-weekly trips down here to deal with the wound vac. My intuition tells me that I could go home in the next one to two weeks. But, I've certainly been wrong before.

So here we are with really no more answers than we had this morning. One thing is for sure--I am taking all promises of going home with a big old grain of sea salt from here on out. We are also trying to contemplate our "plan" for this next chunk of time. Without going into big time logistics, we are trying to decide if maybe Roger will go home to our house on Orcas with all three kids to get them back in the swing of a semi-normal life. Friends and family members would come be with me for wound vac changes on MWF. Roger worries about leaving me, but my only job now is to heal, heal, heal! Plus, the amazing family members caring for our babes could probably use a big break. This is a big decision that we will try to make over the next few days. Please pray that we come up with the best outcome for all involved, but particularly our children. We are so lucky to have these choices in our situation.

I have mentioned before that much as I hate to admit it, there have been great things to come out of this time of awfulness. One of the biggest things that comes to mind is that I have met the most amazing people, most of whom have cared for me in some way or another. Yes, I have had one Nurse Ratchet (always has to be one!), but the rest are phenomenal, loving, and SELFLESS. How many people do you meet these days who are selfless? My answer is not many. I thank God for every one of them.

I go to sleep now with one of my favorite quotes--a simple little comfort to me:

All shall be well
And all shall be well
And all manner of thing shall be well
~Julian of Norwich

Wednesday, January 19, 2011

Beauty in the breakdown

It is morning and i am just waiting for the sun to come out,even if it is behind a bevy of clouds. I went to the bathroom by myself (yay me) without the walker, I just couldn't bring myself to wake Roger to help me...he was sleeping so soundly and continues to do so right now. This makes me feel just slightly less old-ladyish, so that is lovely.

Plus, my Auntie Nia came to visit last night and she did three very beautiful things for me: 1. Shaved my legs (nuff said)
2. Massaged my legs and feet with almond oil (heaven)
3. Tidied up my room and stuff (sounds little but is very big for me right now)

The surgeons have already done their morning rounds, and they told me my wound vac change will be today at 11am, so if you happen to think of me around that time, I would love a little prayer. I am very scared about this, but am trying to remain calm.I am continually blown away by everyone's love, prayer and encouragement. I really do feel it all working within me. No joke. I feel so lucky for that.

Erin sent me some quotes from an author I really like. Here is one of my favorites:
“it really is easier to experience spiritual connection when your life is in the process of coming apart. When things break up and fences fall over, desperation and powerlessness slink in, which turns out to be good: humility and sweetness often arrive in your garden not long after.”
==========
Grace (Eventually): Thoughts on Faith (Anne Lamott)

Even before this happened, I have thought often about how there is "beauty in the breakdown", how weakness allows true strength to come about, but I have to say that I have never been tested to this degree or brought down to my knees as I have through this wretched infection. Still, I am absolutely able to find truth in the quote above, even amongst some of the uglier feelings that come rushing in and out of my mind and heart. At this moment, I am scared. I am powerless in so many ways. But I am also hopeful and content. I know healing will occur. I know my family will be together again, that I will hold my little baby again. I just have to be patient and trust. And breathe. Trust and breathe. Trust and breathe.

Most importantly, as Bernadette reminded me yesterday, I just need to go moment to moment. ANy more than that is too much for me.

I hope all of you have a most lovely morning. As always, thank you for your love, your continued prayer. You are helping to heal me. Happy Day!

Monday, January 17, 2011

The Surgeons Came to Visiit

So, the Surgical Team just came in my room this morning to examine the Wound and the Wound Vac. They are very official, traveling in a group, clad in white coats. Anyway, they seem to think I can go home quite soon IF:

1. We can find a home health nurse experienced with the wound vac. who will come to Orcas Island. We're also looking into the possibility of going off-island to do it (about twice per week to Mt.Vernon or Bellingham),but we'll just have to see.

2. I can handle my dressing/wound vac. changes with only oral medication. Hmmmm. I am really going to have to toughen up, and I think I'll get my first chance on Wednesday, when they change it the first time.

In any case, the surgeons were very encouraging, and said things looked really good, so that is very promising. I appreciate all your kind words in response to my last post...I really needed them. If you feel inclined to pray for the two things listed above, please do so in any way. It is much appreciated.

More later as things develop.