Home again

After a very anxious morning, I came home from the hospital early this afternoon.  Exhausted.  I slept for several hours.  So did both Bill, who has a fever over 100, and Ben, who after exam week and a busy weekend thought he deserved a day in bed.  Are we the walking wounded or what?

The morning was bad because it wasn't until after 1 pm that either the infectious disease Doc here or I was able to reach the MD Anderson plastic surgeon, or anyone there, who knew anything about my case.  the fortress there is really crazy.  When Scott Oates finally called (after I impersonated a doctor to sneak through to talk to the live triage nurse), of course, he was not at all apologetic.  he thinks their system is great and makes complete sense, of course.  More importantly, however, he was not especially worried.

While just not being able to get through was distressing, I also got spun up because no one here really knew what to make of my symptoms, nor knew anything about the temporary graft (Primatrix) and what the symptoms meant for it.  I was admitted for infection, but never had a fever, and the massive blood draw they did Friday night didn't show an elevated white blood cell count.  So the indicia for infection were that my arm was red and very swollen, plus the wound was leaking, where it hadn't been before.  This morning, after 2 and a half days of shock and awe antibiotics, the swelling was down.  And the wound was no longer discharging anything.  But it was just as red, plus hard and a bit swollen right around the wound site.

(If you think I'm exaggerating about being swollen, there was a pretty funny moment when the hospitalist came in on Saturday.  We were talking, and she looked at my puffy hand and said, "I wonder if you have a pulse.  I better check."  Funny because we were talking.  Her concern apparently was that my hand was so swollen it could have closed off the blood flow.)

As a result, the infectious disease doc, who has no experience with Primatrix, was concerned that what was going on was that my body was rejecting the graft, or that there were unacceptable amounts of infection beneath the graft, either of which could require surgery.  Instead, Scott Oates says that these bovine collagen grafts don't have cells, so can't be rejected.  Apparently, they can fall off, too, if there's so much infection under them, but they aren't alive and can't be infected themselves.  And, he's relatively sanguine, given that the wound is no longer oozing, that the reason for the redness is the irradiated tissue not liking the hole in my arm or the graft -- i.e., having been bothered.  Thus, his take is that I will go forward with the vac machine as soon as it can be ordered, and set up, and that I'm probably now looking at surgery more around mid-January, but even that is dependent on how the next couple weeks of healing go.