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admin | Natural Treatment Bacterial Vag | 08.11.2014
A few years ago, a friend told me that I over-analyse things, but I'm not sure really; I'm still thinking about it. It was probably in the middle of August when I first noticed that both of my big toes were a bit sore. As you may remember, I spent four days in my local hospital, during which I received an IV antibiotic (Tazocin), before being discharged on a seven day course of an oral antibiotic (Flucloxacillin), with the plan of having a check-up at the hospital in Sheffield a week later to see how I was getting on.
After I'd explained my medical history, in particular my immuno-suppressed status, and shown my big toes to the podiatrist, we had a discussion about what was the best way forward.
Essentially, I had two main options available to me: Continue with the antibiotics to clear-up the infection, and then either hope that they healed by themselves, or have some form of toenail surgery to help them heal.
My immuno-suppressed status meant that any form of toenail surgery would need to be done by a surgeon in a hospital theatre, in order to minimise the risk of infection; Normally, the procedure would be done by the podiatrist at the local health centre. Fortunately, I didn't have to make any decision there and then, as the podiatrist was just going to write a letter to my G.P. The morning after visiting the podiatrist, the swab results were back, and the infection had been identified as Pseudomonas Aeruginosa. With my curiosity well and truly satisfied, I decided to watch an episode of Grey's Anatomy (an American medical drama).
The day after seeing the district nurse, I'd once again completed the course of oral antibiotics, but my big toes still weren't really looking any better, so I asked what the hospital recommended doing next - I had been keeping the hospital, specifically one of the bone marrow transplant co-ordinators, up-to-date with what was happening, just in case the specialists there had any additional insight to offer, given my medical history, hence the hospital was aware of my situation. The hospital recommended that I made my way in, so that I could be seen by one of the doctors, and in all likelihood be admitted and started on an IV antibiotic (Tazocin). On admission, a whole bunch of swabs were taken, none of which actually identified anything, but the swabs of my big toes were repeated the next day (when they were oozing) and they did confirm the results of the swabs taken at my local health centre, i.e.
The next morning, when the doctors were doing their daily rounds, the roles kind of reversed a bit as I had to update the doctors with what the acute trauma surgeon had said and done, as even though it had all been carefully documented in my medical notes, one of the doctors described the calligraphy as beautiful but illegible.
I'm told the specialist arranged by the acute trauma surgeon did come to see me, but unfortunately it was whilst I was having the echocardiogram, hence that meant waiting another day for the specialist to return. We had a chat about my big toes, which once again went along similar lines to the one that I had with the podiatrist, and the result was that I could go home on a different oral antibiotic, i.e. Later that day, one of the doctors came to see me, and started to apologise that the specialist (who is based at a nearby hospital) had once again not turned-up, and to address this issue arrangements had been made for me to go and see the specialist instead, as that would make it easier for us both to be in the same place at the same time. Later that evening, after I'd remade the bed from the sheets I'd carefully tied together to lower me to my escape, another doctor came to see me (someone more senior).
Surprisingly, we had only been sat in the waiting area for a few minutes, before we were called in to see the orthopedic surgeon.


As you might imagine, I was also kind of between a rock and a hard place, as I had two highly qualified and experienced medical professionals, albeit in very different specialties, recommending quite different treatment plans; I was just the lay person in the middle trying my best to not sound like some kind of crazed hypocondriac - I can't help but think that the orthopedic surgeon would likely say that I was unsuccessful!
As we made our way back in the taxi, I was thinking everything through, and could see how the consultant would likely not be very happy with the plan recommended by the orthopedic surgeon, so given that the nurse that worked with the orthopedic surgeon had given me a phone number that I could use to get in touch, I thought I'd give the nurse a quick call to make sure I'd understand what had been said, and that I'd clearly explained the issues around my medical history etc.
Shortly after talking to the orthopedic surgeon on the phone, one of the doctors came to tell me that my discharge was being arranged, as recommended by the orthopedic surgeon, and that I'd go home on some form of oral antibiotic(s), i.e.
Amusingly, as I was talking to the doctor, I found myself a bit distracted by one of the other doctors clearly struggling to find the meeting point between the curtains that had been pulled around my bed for privacy; I couldn't help but smile really, as the doctor in question had not particularly inspired me with confidence on prior occasions, hence being outwitted by a pair of curtains was kind of the final nail in that coffin, so to speak.
Essentially, after a few quick questions about the likelihood of the surgery being successful, and the probability of getting an infection, I really just had to sign the consent form, and go to the pre-operative assessment clinic, where they would do a few routine tests to ensure that I was ready for the surgery. There was another topic that was briefly discussed, and that was whether it was worth having an x-ray or MRI of my feet to see if the infection had spread to my bones, as that would mean changing the treatment plans somewhat. We had to wait a bit before we could make our way to the pre-operative assessment clinic, as one of the nurses needed to check whether they could squeeze us into their schedule - Ideally, as soon as possible, as we needed to get back to the other hospital really. At the time, we didn't really understand the comment about being brave, but it wasn't long after we were pointed in the direction of the pre-operative assessment clinic that it started to become clear, as everyone in the queue at the reception desk felt like they had been put in the naughty corner when they were asked to take a few steps back to wait in the designated area. When we were called, we cautiously took the few steps forward to the reception desk, each of us wondering who was going to be the brave one that explained why we were there - It turned-out, it was the member of the medical staff that had come with me. The receptionist called the number that we provided for the taxi, but was asked to try again in half an hour when someone would be back from lunch. The next day, one of the doctors informed me that I was being discharged, and that I would go home on some concoction of oral antibiotics, which would hopefully keep me heading in the right direction, and that I would need to return a few hours before my toenail surgery for a couple of platelet transfusions, in order to prevent excessive bleeding. Whilst waiting, another doctor (someone more senior) stopped by to say that, after a discussion with the orthopedic surgeon, it seemed that in all likelihood my discharge would be cancelled; I likely needed to stay on the IV antibiotic, as there was some concern that the concoction of oral antibiotics wouldn't suffice, which would prove problematic for the toenail surgery. Later that day, yet another doctor told me that I could go home, as originally planned, if that's what I wanted to do. Two days later, the decision about whether to go home for a few days was pretty much made for me, as it wasn't long now before the toenail surgery, so it seemed kind of pointless risking the concoction of oral antibiotics for the sake of a bit of time at home. The only problem with choosing to stay in hospital (putting aside the delightful cuisine) is that there isn't a great deal to do. As I mentioned earlier, I needed a couple of platelet transfusions before the toenail surgery, and it turned-out that the kind donor(s) had shared almost double the normal volume, which made the timing tight, so they were transfused (one after the other) at the maximum rate that the IV pump could handle. After I'd been transported to the nearby hospital where the toenail surgery would take place, I had a surprise visit from a member of the physiotherapy team, as it turned-out that I needed crutches after the toenail surgery, as I'd likely struggle with walking for a bit, given both of my big toes were being operated on. It had been a long time coming, but the weekend had passed, and it was finally time for the toenail surgery.


It wasn't long before it was time for the orthopedic surgeon to start the ball rolling, which meant injecting the local anesthetic into both of my big toes.
As I was pushed into the theatre on an operating bed, I remember thinking that all of the gadgets made it look pretty impressive, but perhaps more memorably I decided to comment that the medical team (in their surgical gowns) looked like the teletubbies. Essentially, after checking that the local anesthetic was working and tourniquets had been applied to stop my blood gushing out, the toenails could pretty much just be pulled off.
Once the toenail surgery had been completed, I had to slide my way on to a hospital bed, so that I could be taken to another room for an hour or so, where my observations could be checked regularly, before being transported back to my hospital of origin.
Unsurprisingly, after having your feet operated on, it is recommended that you keep them elevated to prevent excessive bleeding.
Unfortunately, despite my feet being elevated, later that evening (and through-out the night) they bled quite a bit. Initially, some additional dressings were added over the top of the existing dressings, in order to help stop the bleeding, but later on those dressings were removed, as well as part of the original dressing on one foot, as they were all soaked with blood.
It was actually the concrete like boots that resulted in yet another discharge being cancelled; I'd asked whether the dressings could be replaced, as I didn't want to go home with them squashing and digging into my feet, unless I really had to do so.
The next day, one of the nurses had managed to contact someone to check about replacing the dressings, and I could finally get rid of my concrete like boots, and head on home!
Both the nurse and myself had hoped that once the dressings were off, it would just be a relatively simple job of applying some new dressings, and I'd be ready for going home. On the 12th of December (day +315), I actually made it all of the way through the discharge process, and went home with my usual medications, some tranexamic acid tablets, and the concoction of oral antibiotics that would hopefully keep me infection free.
Note: I had wondered whether I might be prescribed Vancomycin, as that's what I was given when I actually had C.
The next morning, the dressings were still a bit awkward to get off, but nowhere near as bad as the previous day. Diff; My thinking was that if it could be used to treat it, then perhaps it could be used to prevent it too - The doctors didn't seem sure either though, as it's not something they'd normally do.



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