I began this from the side of a bed at a hospital in Rowlett, Texas. It’s quite the story, so please bear with me as I tell it.
This entire ordeal began with the big toe on my left foot. It developed a condition called hammertoe after I fractured it and had it surgically repaired several years ago. The condition itself wasn’t painful, but in my case an ulcer formed on the bottom of the toe that, according to my orthopedic surgeon, was about to “break through.” The hammertoe needed repair, and it needed it quickly. So, on the morning of June 28th, 2021, I checked into the outpatient department of the same Rowlett, TX hospital mentioned above to have surgery done.
The surgery was rather straightforward: straighten the toe, fuse its bones together, and insert a screw through the tip to hold the repair in place. The operation went smoothly, and I was home relatively quickly. I did have a bit of post-operative bleeding and some raw skin on my leg caused by the surgical boot I was forced to wear, but that was it. Both were addressed at my follow-up appointment a week later, when the surgeon replaced the dressing with a fresh wrapping.
This marked the beginning of all hell breaking loose. In a small way.
My foot was swollen when the doctor replaced the dressing. My left leg was also swollen, but not from the operation. You see, I suffer from chronic edema, or swelling of the lower extremeties. This, coupled with the swelling in my foot and the relative tightness of the new dressing, eventually resulted in quite a mess.
Said mess was on the brink of developing when I went back to the surgeon to have my stitches removed and dressing changed a week later. When he removed my dressing, it was obvious that it had acted as a sort of tourniquet, squeezing my ankle and foot to the point where they had become relatively “skinny,” while the portion above and below the main wrapping (including the big toe) had swollen dramatically. My surgeon examined those areas and proclaimed that they would be okay with time plus the use of a compression stocking. Indeed, nothing looked infected or otherwise out of the ordinary aside from the swelling – all tissues were white and normal.
The morning of the very next day, Saturday the 10th of July, my wife helped me into a compression stocking. I wore it without issue for most of the day, even falling asleep while wearing it sometime after noon.
Remember all hell breaking loose? Here’s where it officially broke out of its bonds.
Around 2:00 p.m., I was awakened by a throbbing, stinging pain in my left big toe. It was excruciating, hitting me in waves that came several seconds apart. I called the on-call doctor at the surgeon’s clinic and was told to give it a couple of hours. If it didn’t improve, I was to go to the Emergency Room. Two hours later, that’s where I found myself. A few hours after that, I was admitted to the same Rowlett hospital where the surgery was done with several IV lines coming out of my left arm, some of them carrying potent antibiotics.
At one point during the week that followed, I was on four IV antibiotics at the same time. The doctors finally settled on two extremely powerful ones: vancomycin and Rocephin. (Vancomycin, in fact, has to be monitored via blood tests: too much in the bloodstream can be toxic.) They had been giving me Dilaudid for my toe pain, but by the end of the week they’d brought the dose down to almost nothing.
By Friday, they were ready to discharge me, since they’d determined I did not have a bone infection or a blood infection – just “cellulitis,” or infection of the soft tissues. They took me off of Dilaudid altogether, set me up with home delivery and administration of the antibiotics, and sent me on my way. (There was a major snafu with the home health service and the administration of the IVs, but that’s another story.) I then spent the weekend and most of Monday getting used to home life again.
Monday evening. To mangle-quote the Eurythmics, “Here Comes the Pain Again.” My big toe ran up to a level 8 out of 10 pain. We removed my sock and checked it out: it was red and angry again. My wife asked me if I wanted to go back to the ER. I said, “Yes – I’m afraid I might lose the thing.” So, back to the ER we went. Several very long hours later, I was readmitted into the hospital, but with the puzzling diagnosis of only “Toe Pain.” All of my diagnostic tests were coming back negative – no new infection, and no chemical signs that the one I had was getting worse. Only the physical signs of pain and increased redness showed that it was worsening.
My surgeon saw me a day or so later in the hospital. (He’d missed me during my first admission, since he’d gone out of state for the week.) Once he finally got to see me, he decided that all was not quite hunky-dory. He wrapped my leg up in ACE bandages to apply compression in an attempt to squeeze out the swelling in my leg and foot. These stayed on for several days (I’m wearing them still as of July 29th). He also told me that cellulitis was notorious for being painful, so that was probably what was causing me pain.
The other doctors tweaked my antibiotics, changing my Rocephin to Cefepime (a broader-spectrum IV antibiotic) and decreasing my vancomycin dosage from 1500 to 1000, since I was flirting with toxicity at home. They also put me back on Dilaudid, eventually tweaking it up to its current dose and frequency.
The most recent thing the hospital doctors did was decide that they couldn’t treat me in a hospital setting, nor could my wife and I (nor home health) treat me at home. So, on the evening of Sunday, July 25th, they transferred me to Kindred Hospital Dallas Central, a Long-Term Acute Care (LTAC) facility. That is where I am now, and it is from the bed of my room there where I am writing this story.
I shall provide updates on the main page of my web site as they become warranted. Don’t hesitate to ask questions if you have any via my web site’s contact page. Thank you for reading!