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Friday Mar 13, 2020 #
Note
I will be discharged home from Northeast Rehab in Manchester tomorrow. This will end 47 inpatient nights between 11/22 and 3/13 at Concord Hospital, Mass General and NE Rehab. 32 were at MGH, the second admission being 3 weeks long to the day - Valentine’s Day to March 6th. I had a 10 hour surgery on 2/19 for spinal stenosis/compression at multiple levels due to sequellae of vertebral osteomyelitis/disciitis. I now have two fusions, from T2 to T8 and from T12 to L5.
Definitely life-altering, time will tell how much . At the rehab, I was basically gaining proficiency with a walker and starting with a cane. I went to MGH on 2/14, afraid I’d be unable to get to the car. By 2/15, I was not able to stand, in part because I’d entered the sit-lie world of acute care but more so because my legs couldn’t do it…a combination of weakness and lack of coordination.
2019 was about increasing back pain always thought to be mechanical. There were no recurring signs of infection. Finally, on 11/22, I had an MRI of the lumbar spine which showed infection and was hospitalized to initiate IV antibiotic therapy. This eventually caused some nephritis and acute kidney injury which cleared when the antibiotics were stopped and then changed. However, it was not evident what organism was causing the infection until, during surgery, a culture of sufficient live organism sampling revealed what species of organism and which antibiotics might work. The chosen antibiotics didn't work, the infection got worse, surgery was required. Post-op, I am on 4 different antibiotics.
The big question, only answered this past Wednesday, is where did it come from, what caused it? Infectious disease at MGH told me that Chimaera, a non-tuberculous mycobacterium (MAC complex) species, grew from the culture. ID said it was a first at MGH, ie, I was the first patient to grow this organism in a culture. It was pointed out that Chimaera has been found in heart-lung bypass equipment. Vertebral osteomyelitis is not at all common in healthy individuals with no significant medical illnesses and on no “powerful” medications, eg, immunosuppressants.
The admitting Friday was Valentine's Day and the final night hospitalized and fourth Friday, Friday the 13th. Time may be more forthcoming with specific thoughts on the nature of acquiring this infection. Regardless though, it’s move ahead, literally one step at a time. I hope to be connected with orienteering in one fashion or another before long. But first things first, like fresh air!
Definitely life-altering, time will tell how much . At the rehab, I was basically gaining proficiency with a walker and starting with a cane. I went to MGH on 2/14, afraid I’d be unable to get to the car. By 2/15, I was not able to stand, in part because I’d entered the sit-lie world of acute care but more so because my legs couldn’t do it…a combination of weakness and lack of coordination.
2019 was about increasing back pain always thought to be mechanical. There were no recurring signs of infection. Finally, on 11/22, I had an MRI of the lumbar spine which showed infection and was hospitalized to initiate IV antibiotic therapy. This eventually caused some nephritis and acute kidney injury which cleared when the antibiotics were stopped and then changed. However, it was not evident what organism was causing the infection until, during surgery, a culture of sufficient live organism sampling revealed what species of organism and which antibiotics might work. The chosen antibiotics didn't work, the infection got worse, surgery was required. Post-op, I am on 4 different antibiotics.
The big question, only answered this past Wednesday, is where did it come from, what caused it? Infectious disease at MGH told me that Chimaera, a non-tuberculous mycobacterium (MAC complex) species, grew from the culture. ID said it was a first at MGH, ie, I was the first patient to grow this organism in a culture. It was pointed out that Chimaera has been found in heart-lung bypass equipment. Vertebral osteomyelitis is not at all common in healthy individuals with no significant medical illnesses and on no “powerful” medications, eg, immunosuppressants.
The admitting Friday was Valentine's Day and the final night hospitalized and fourth Friday, Friday the 13th. Time may be more forthcoming with specific thoughts on the nature of acquiring this infection. Regardless though, it’s move ahead, literally one step at a time. I hope to be connected with orienteering in one fashion or another before long. But first things first, like fresh air!