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Necrotizing Fasciitis took over our lives in 2000
| Day |
Date |
Events |
Nurses |
| 1 |
3/21
Tue |
Steve complained that the area under his left arm was swelling and painful.
He persevered through on-line traffic school despite the discomfort, and went to
bed thinking his lymph nodes were swelling due to the start of a flu bug. |
N/A |
| 2 |
3/22
Wed |
The complaints changed from mild to more serious pain. Fever and further
swelling became new clues, as well as pain on the left side of his chest and
more pain going down the arm. With the help of his younger son Jason, he visited
our family doctor, who agreed with Steve that the symptoms were the likely
result of the flu.
After a shot to help him keep his food down, he went home to get some rest
for the night.
|
N/A |
| 3 |
3/23
Thu |
The other shoe dropped. Steve woke at 7:00 to make his customary
weekday phone call to me in my Moorpark, CA apartment. He sounded horrible, told
me he was having problems with diarrhea, and that he couldn't get out of bed.
Fearing complications of the flu, and believing he was dehydrated and possibly
in danger, the McDaniel clan sprang into action.
Kris called Debra, asking that she send Jason to Steve. She convinced Steve
to not only go to the hospital, but to take an ambulance so that he didn't have
to try to figure out how he was going to get to the hospital when he couldn't
get to the bathroom.
Jason provided the legs and arms to get whole process underway, not only
dialing 911, but convincing them to send an ambulance. He then stayed behind to
clean up the mess of a sick guy that couldn't get out of bed -- all over a brand
new mattress.
Once in the hospital, more ideas were floated as to the cause of the illness.
His doctors believed that he might have the flu and need IV fluids, but that
didn't quite seem to fit. Then blood tests indicated Steve had a recent heart
attack. Still later, the heart attack was determined to be the result of the
malady, not the cause. Further consultations indicated the swelling, redness,
and pain might be a rare condition called necrotizing
fasciitis -- a.k.a. flesh eating bacteria.
Steve was whisked into the operating room for surgery intended to pin down
the possible diagnosis. His surgeon's fears were confirmed; the appearance was
consistent with the theory. To be certain, and to determine the treatment
course, tissue samples were sent for analysis. The affected tissues in the
infection site were removed (debrided).
Steve's infection was progressing rapidly, toxins moving freely throughout
his aching body. He was moved to the Surgical Intensive Care Unit (SICU). After
further evaluation, it was determined that he would receive three
different antibiotics until the tissue samples came back with a positive
identification of the specific bacteria that was damaging Steve. He was
having difficulty breathing, so he was placed on a respirator. At that
point, in order to keep him calm while on the respirator, he was sedated.
Lights out...
|
Judy 1 (N) |
| 4 |
3/24
Fri |
Steve spent most of today trying hard to fight
his infection. As these things go, following surgery he felt even worse. A
high fever (104) developed, and the main order of the day was to keep the
fever under control.
There was a rapid spreading of his infection. Dr. Patterson drew lines
on his body with a pen so that he could get a visual indication of the
rate of progression. |
Mary Jane (D)
Leah (N) |
| 5 |
3/25
Sat |
Steve's fever maintained at a lower level, from
about 100 to 102. His infection spread some more, but it didn't appear to
be progressing at the same rate. His nurse drew a new line on his body to
mark the change.
And we waited... |
Nancy (D)
Leah (N) |
| 6 |
3/26
Sun |
Steve's fever was at a somewhat lower level
again, hovering around 101. Judging from the lines drawn on his body
earlier, his infection had significantly slowed in its progress, but was
still spreading.
So we waited some more... |
Roxanne (D)
Judy (N) |
| 7 |
3/27
Mon |
We had a bit of a scare when Steve went back in for surgery the second time.
He had been showing signs of discomfort, his fever remained elevated, and a swelling was found that looked
like it might be a new area of infection.
Surgery proved it was edema and not infection. After draining the built up
fluids and cleaning out a prior area of infection again, he stabilized. Its so
unusual to be so fortunate! We are really happy with how well he is doing on his
long road to recovery.
A new, small CD/Stereo was added to the treatment plan. He started out with
the Enchanted Works of Stevie Nicks collection. Now his nurses and I are setting
about finding the right music to encourage a healing mood.
|
Adele (D)
Judy (N) |
| 8 |
3/28
Tue |
Steve stayed a lot more stable today. His fever stayed down, his blood
pressure stayed up, and he responded well to a small reduction in the respirator
support, to 10bpm (breaths per minute). He opened his eyes a tiny bit and moved one arm. It is slow moves all
the way...
I brought in a small CD rack with several choices so that he'd be able
to get some musical variety. |
Adele (D)
Judy (N) |
| 9 |
3/29
Wed |
Steve's been a lot more aware today... unfortunately what he
seemed to be aware of
most was that his side and arm were hurting from where he had surgery. He spent a day
adjusting to another small reduction in respirator support (8bpm), and moved to a new
anesthesia, Versed. He couldn't hang forever on that anesthesia because
its not a good long-term choice, so it was time for the switcheroo.
He went back on a higher level of anesthesia in the evening so that he
would be able to rest more peacefully.
Although he started the day with Mozart and Stravinsky, by the end
of the day he was again resting to tunes by BB King. |
Jana (D)
Lori (N) |
| 10 |
3/30
Thu |
Steve started the day with a temperature of
103, which was quickly brought into control by Adele. He stayed on the
higher level of anesthesia so that he wouldn't be uncomfortable while
continued resting. He spent another day at the same level on the
respirator, 8bpm.
He listened today to a variety of music, including Tina Turner, BB
King, Mozart, and the Great Ladies of Jazz |
Adele (D)
Robert (N) |
| 11 |
3/31
Fri |
Steve was mainly cruising along on his
anesthesia and pain killers. His respirator was kicked down another notch,
to 6bpm. Resting and staying quiet were the orders of the day.
He listened again to BB King, along with Pink Floyd, Mozart, and
Mahalia Jackson. |
Eva (D)
Michele (N) |
| 12 |
4/1
Sat |
Steve began the morning with his respirator set at 4bpm.
Throughout the day, his temperature and temperament remained steady. His
white blood cell count was still high, but his lungs are still mostly
clear, and he's coughing on his own more productively. Things are looking
good. |
Sherry (D)
Lori (N) |
| 13 |
4/1
Sun |
We're hoping Steve will get off the respirator
today. More later... |
Sherry (D)
Lori (N) |
| 14 |
4/2
Mon |
Steve was moved out of the surgical intensive
care unit (SICU) to the cardiac rehab ward today, even though he is so
sick he can barely sit up, much less stand. It turns out the original
evidence he had a new heart attack appears to be misleading. More tests
will be needed to see whether his heart has suffered permanent damage from
the ordeal.
Steve was placed in a chair to see how long he can sit upright. It was
extremely uncomfortable, but necessary. |
Sherry (D) |
| 15 |
4/3
Tue |
Steve took his first steps into the hallway,
supported by a walker and accompanied by a physical therapist. He walked
about 20 feet. |
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| 16 |
4/4
Wed |
Today Steve walked all the way to the nurse's
station and back, still supported by a physical therapist. He has walked
about 50 yards today. |
|
| 17 |
4/5
Thu |
The final tubes came out today. Steve was
removed from IV fluids and antibiotics, and the feeding tube in his nose
was finally removed.
The feeding tube was an exceptionally difficult battle. While Steve was
still having real trouble swallowing clear liquids and even some thicker
foods, he couldn't keep any more access points open to infection. We
elected to risk another pneumonia from aspirating thin liquids into his
lungs because the alternative -- resistant bacteria only a hospital can
incubate -- would produce an even more difficult battle to fight.
So now Steve is taking his antibiotics by mouth and simply dealing with
his difficulties with swallowing. One more night, and he's been promised
he can go home. |
|
| 18 |
4/6
Friday |
Steve was finally allowed to go home today |
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Steve's Doctors
Steve's primary doctors through all of this were Gary Johnson, Theodore Mazer, A. James Behrend,
Patterson, and Larry Emder
Gary Johnson, DO, DVM
Dr. Johnson is Steve's primary care physician. We've both seen him for years,
and have always appreciated his warm and caring approach to us. Gary was
instrumental in ensuring that Steve got released from the hospital so he could
have the care he needed to recover fully at home.
Theodore Mazer, MD
Dr. Mazer is Steve's cardiologist. He has been following Steve since his 1995
heart attack and triple bypass surgery. Dr. Mazer made a huge contribution by
alerting the emergency room physicians to the fact that Steve was not
having a heart attack as they first assumed, and urged them to look further for
the cause of all of his symptoms, rather than just the ones that
looked familiar to them.
A. James Behrend, MD
Dr. Behrend is Steve's surgeon. When first looked at Steve, he realized he
might have this nasty bacterial infection, and immediately took him to surgery
so a diagnosis could be pinned down. From what I have been told, this is a very
tough diagnosis to make early. Everyone can tell what's wrong once its been in
progress awhile, but by then it can be too late. We are very grateful to him for
making his guess soon enough for Steve to have an excellent chance for a full
recovery.
Patterson, MD
Dr. Patterson is an infectious disease specialist with a caring soul and a
very positive reputation with the nurses in ICU. He has watched over the
infection as it advanced and then receded. I appreciate his candor all the way
through this adventure. He never left me feeling like I didn't know what was
happening.
Larry Emder, MD
Dr. Emder is the pulmonary specialist that's been treating Steve with his
army of therapists since he first came in. He has watched closely for every
nuance that could indicate a respiratory problem. I appreciate the concern he
has shown all the way along, as well as his candor with me. Because a
respiratory failure is one of the most serious potential complications resulting
from the treatment of this infection, I couldn't be more grateful that he's been
so thorough.
Steve Today
Steve's been fully recovered for some time now, although he remains
susceptible to respiratory infections. He's been operating a skid-steer loader
doing small jobs for homeowners and others, and has been raising a wonderful
group of Siberian Husky puppies which have been placed with families all over
Southern California and beyond.
We're grateful beyond words for the life he's been able to live since
recovering from the disease that very nearly took his life.
This page was last modified on
Friday, 24 August 2007
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