WARNING: Irrational, But Necessary, Vent

There is no way around it.

Yesterday, Wednesday, I sat, absolutely transfixed, and watched an encore presentation of the Duke/Texas game from last Saturday.

Only I did not recognize it as something I had already (and pretty intently, too) watched -- until that flagrant foul at about the 5 minute mark in the second half repeated itself.

"Odd," thought I. "Strange. This same foul happened at about this same time... Oh!"

Yes, this is The Retired Educator's version of light bulb moments. Other people have sudden revelations about God, Science, Right, Wrong, Fashion, Politics, Morality, and, above all, Good Eats. Me? It's more along the lines of Pitiable Déjà Vu.

Correctional light bulb moments. Orthopedic light bulb moments.

About four days after we had to stop the Daptomycin due to increased pain and sky high CPK, my fevers settled back into their daily routine. Afternoon misery, evening exhaustion, limited 2-hour spurts of sleep, sweats.

Pain. The right shoulder is doing well, I think. There is a little squish and kerplunking these past few days, that's all. The left, which still has the spacer, hurts a lot. As in "a lot." Also, both knees, the left hip. Funny that of all my operated joints, the first one done remains intact and painless -- the right hip replacement.

I saw The Boutiqueur last Thursday, had the bloodwork done that Infectious Disease Man wanted. The results scream infection. Again.

I haven't breathed one word about the knees and left hip, and only just realized why a few hours ago -- on the ride home from Dr. PainDude's office.

This is embarrassing.

I have become very trusting of the orthopedic surgeon who has pulled me through the last four surgeries -- I honestly believe the man (and his team) has saved my life several times now. He specializes in shoulders.

As in: He does not do knees. He does not do hips. He does shoulders. Only. Sure, I bet he could successfully operate on any bone/joint but this is how the orthopedic game of super-specialization is played.

And I've become such an emotional and mental weakling that I cannot see starting this difficult process over again with one of his partners.

It seems to me that this would be a good time to repeat the scans that we did last summer -- the bone scan and the gallium scan. Because maybe I am wrong about the knees and hip. Of course, I haven't been wrong yet -- there where the pain is very bad, there has been, well, beaucoup pus. (Sorry) And *something* is infected (in a form that cannot be reached by i.v. antibiotics!).

The kicker in this complicated situtation? Infectious Disease Guy and OrthoMan both have ordered, between them, four different joint aspirations into what we later found were very infected joints. WHATEVER PATHOGEN IS INVOLVED HAS NOT GROWN IN THE LAB. In each of the four most recent surgeries, extensive sampling was done. Admittedly, in the first surgery, at the tail end of August, SumDood kind of bungled the microbiology -- the samples were left overnight in the Operating Theatre. But since then, there have been biopsies and cultures galore... and WHATEVER PATHOGEN IS INVOLVED HAS NOT GROWN IN THE LAB. I have had to be in isolation with each hospitalization due to testing positive for MRSA in My Sweet Nares and one Beloved Armpit, and have taken to bathing in caustic hot pink Hibiclens and snorting antibiotic ointment. I know! Very sexy!

I have had 3 six-week courses of i.v. vancomycin, plus 2 six-week i.v. courses with sumpthin' I cannot remember, and this latest effort with i.v. daptomycin -- which only lasted about 10 days.

When I confessed to Extreme Fatigue chez Le Boutiqueur, he said the infection is just sapping me, and the daily fevers are keeping me dehydrated and defunkified (he thinks that is behind the sudden hypotension when I stand up... and pass out). Some of my electrolytes came back skewed -- who knows? I only know that if I have to be such a limp noodle, I ought to be gifted with some good sleep to go with.

So, class, let's summarize.

Two hours sleep per night. (Not entirely true. I am having some good nights, interspersed.)
Temp of 100.9.
WBC around 14,000 with funky shifts involving the neutrophils and stuff... (absolute neutrophils are at 11425)
C-RP 3.9 -- which apparently sucks rocks.
Alkaline Phosphatase 145 (My understanding is that this is indicative of nothing in particular...)
GREAT NEWS -- CPK is now normal. Par-Tay!
Fatigue and pain out the WhaZoo (alt. spelling)
Blood glucose out of control -- well, over 200, and that was fasting. Boutiqueur says it may well be the infection causing that.

We have yanked out both shoulder prostheses -- the left had been replaced in 2002, the right in 2005. The left never had much of a chance for success. The right was a great job from the get-go. That old get-go! When OrthoMan opened up the right side (he had done the replacement in 2005), there were four huge abscesses, and I didn't do particularly well -- so he stopped at mid-point and put me in ICU on a vent for 4 days, then went back in and finished. A Twofer. Then last month, he removed the spacer and put in a total shoulder prosthesis.

When he operated on the left side, initially he thought it looked great. Before closing, he decided to bore a little into the humerus underneath the prosthesis post, and, in his words, "it exploded." So, at that point, I graduated from yer olde ordinary prosthetic joints infections to "osteomyelitis."

I go back to OrthoMan next week, April 1, and we are to discuss what to do next.

I don't think I can bear bringing up these new problems. Him, I trust. And his colleague who reconstructed my elbow in 2007, I trust him, too. The quality of their work as surgeons is wonderful, and the quality of their "doctoring" is also. They have to keep a look out for problems with adrenal failure, lupus flares, CRPS/RSD -- and I have to say, they have been great about *trying* to prevent CRPS spread. It has spread but I do believe their efforts have kept it from being much worse.

Oh, hell. If I vent and kvetch and bitch and moan and get it all out before I see him, maybe my brain function and ability to trust will have returned.

Fred just told me to depend on him, that he will make sure that I am ensconced in the big bed with him and My Buddy, La Bonne et Belle Bianca -- with popcorn and various Belgian patisseries, and some bonbons on Manager's Special -- at precisely 3:12 AM -- that's when T.V. Tête de Hergé will carry Duke's trouncing of Villanova.

Live, at Marlinspike Hall!

So good luck to Duke and to Carolina, too. Villanova and Gonzaga will make sure these are closely contested matches. A lot of good it'll do them, Harumph!