After a couple of the attending liver doctors finally came in yesterday morning on regular rounds to examine Linda, they reached the preliminary conclusion that her right flank pain and the redness over the right half of her transplant incision [which you may recall was reopened several extra times] could be caused by an infection. This is of particularly grave concern, since the large surgical mesh they put inside her after the chest tube punctured her liver will act as a wick and spread any infection quickly all the way across her abdomen and up along her breastbone following the line of the incision. Dr. Fridell asked if they could do a CT scan to further investigate the possibility of infection. When I asked him whether he had spoken about this with anyone from the infectious disease specialty, he said the infection doctors usually only consult on "opportunistic" infections, and leave the diagnosis, care and treatment of surgical wound infections to the surgeons. I politely inquired whether he would invite a consultation from them in Linda's case in spite of that tradition, and he reluctantly agreed. I said I wanted to hear from the infection doctors before agreeing to a CT scan.
Early yesterday afternoon a platoon of three female physicians from the infectious disease service came to examine Linda. The nursing staff had forewarned them to look over her whole chart and be prepared to answer questions I might have before coming in the room to examine Linda, which they apparently did. After they examined Linda's abdomen as well as the redness around her chest tube insertion site, and took her temperature, they told me their initial impression is that Linda does in fact have an infection in her incision line, and that under the circumstances of her situation, their primary concern is that the organism is MRSA - Multiple [antibiotic] Resistant Staphylococcus Aureus - also known as flesh eating bacteria. They agreed the CT scan would be a good idea, and they prescribed Vancomycin, one of the few drugs which still has some effectiveness against MRSA, to cover Linda while the complete their investigation of her infection. I agreed to the CT scan, which was done yesterday afternoon at 5:30, but we don't have a result yet.
Once the platoon of infectious disease doctors left the room, I cried harder than I ever have since losing a baby when Gabriel died many years ago.
I have seen the results of MRSA infection in a surgical wound. Besides antibiotics, the treatment is reopening the wound, cleaning out the dead tissue, and leaving the incision - in this case all the way across Linda's abdomen and up her breastbone to the place you put your hand over your heart when you sing the "Star Spangled Banner" - open in its putrefying and stinky glory for four to six weeks until all the germs are killed and the wound can be safely closed. It's an ugly, nauseating and terrifying process which leaves huge, red, keloid scars in its wake, if the patient survives. Linda does not deserve this. Linda has never done anything to anyone to have deserved any of this.
As I write these words I am so sick to my stomach I know I won't be able to eat any breakfast today. I cried all night. When Linda woke at 2:30 in a pool of her own diarrhea, fiery with fever and shaking with chills at the same time, and the nurses came in to clean her up and try to comfort her, I played the CD Coleen and Kelly from Sylvan mixed for her - twelve wonderful songs by "kick ass" female artists. The music seemed to calm her as the nurses worked on her.
I would trade places with Linda in a hearbeat to take this horrible burden from her if I could. I cry uncontrollably whenever I look over and see her suffering and in pain. I haven't had the courage yet to describe to her what she is probably facing in the next several weeks. She still smiles when the physical therapists come to the room to torment her with the monumental effort it takes her just to sit up on the edge of her bed, hold her head erect and try to stand up with the help of two of them for a few seconds. She smiles at them again when they leave and say they will come back the next day to do it all over again. Her courage in the face of all that has happened and all that will be required to recover from it is indomitable, and the only inspiration I have to keep me from collapsing into a heap of depression and pity for us and for her. I am certainly the luckiest man in the world to have been loved by her all these years.
I feel like a cornered animal as I sit here waiting for the prognosis from the infectious disease doctors. I have to remind myself every minute not to let my own fears and dread sap the strength I will need to help see Linda through the rest of the ordeal to come. As I fight the bureaucracy of the hospital and health insurance, doctor ineptitude and nursing negligence we are encountering, and feel the weight of these things on my stamina and strength, I can only imagine the toll Linda's effort to deal with the things imposed on her throughout this torment has taken on her strength and spirit. Without her as a teammate I would have broken completely long ago under the strain.
I can't thank each and every one of you enough for the emotional and spiritual support you continue to provide to Linda and to me as we take one miserable day at a time working through the depths of despair to what we continue to hope will be a better, more healthy, long, comfortable future we can celebrate with all of you.
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