I spent the last two months dealing with a very sick son (Michael).
He injured his heel on the last day of school (June 12th) playing ‘Capture the Flag’.
We didn’t think it any more than a sprain at first, but he gradually limped more and more
and we went to his PA the next week. They X-rayed him and found nothing and gave him
an ‘air cast’ to support it until he could get an MRI scan.
We got a prescription for Tylenol 3 (Codeine) (800mg) because he couldn’t handle the pain
Well, Michael still couldn’t sit still for the MRI. They insisted on trying to put his foot up ON the heel and expected him to
hold it there for 20 minutes…
We had to go back to the PA.
I wasn’t going to wait around while they make an appointment, so I walked in
with my son who was weeping and moaning so the doctor would ‘get the picture’.
No luck, they can’t think ‘outside of the box’.
The pain was getting too much for him and we had to go the ER that night. They X-rayed the foot again and
gave us , Oxycodone (500mg) and Motrin (600mg) to tide us over. He had a small red bruise on his heel and lots of pain.
I went back to the PA the next day. One of the receptionist muttered ‘ER’ when we walked in. I nearly lost it at that point.
The PA told me he couldn't do anything without the MRI and he gave me Valium to sedate him for the next MRI.
We went home again. The MRI was scheduled for Monday am. Meanwhile, I’m feeding the poor kid Oxycodone
day and night.
We couldn't even get Mike into the car to go for the second MRI. He was in too much pain.
We called the Doctor's office and they said they would set up an 'appointment' with
a local bone doctor... they dillied and dallied for a day. My wife called the bone doctor's office and begged for an appointment the next day.
We managed to get him into my wife's SUV and took him to the bone doctor. We had to sit around for a while. When she (bone doctor) unwrapped his bandage and look at his foot, she just looked 'apalled', re-wrapped it and call the local hospital to have him admitted while she tried to get him a bed at Uuniversity of Michigan Childrens hospital (The C.S. Mott ). She scheduled him for an MRI the next morning 'with morphine'. (Magically , they were able to do the MRI this time without having him
put his weight on the infected heel..)
When the bone doctor saw the results she immediately called the University of Michigan for a bed because of the extent and strength of the infection.
(It was eating his heel bone and pad at this point).
The put him on ‘Vancomycin’ and ‘Gentomycin’ - antbiotics used for Staph or super bug infections.
We waited at the local hospital for 2-3 days. They only unwrapped the bandage once
and, even with morphine, he was in extreme pain. (see below)
July 4th we got a bed in U of M and went there by ambulance.
They put him on Vancomycin and Zostrin antibiotics.
He was scheduled for surgery the next day by Dr. Caird, the assistant professor of Pediatric Orthopedic surgery.
They originally said he would be 3 or 4th, but she came in early 5th July and very carefully unwrapped his heel to take a look (Mike barely felt what she was doing, she was so careful - see above). She bumped him up to 1st in line for the OR
on July 5th.
She came out after the surgery to speak to me and my wife, Cathy. She was confident she has removed most of
the infection, but it was all over the arch of his foot and travelling up his Achilles tendon. He had lost a lot of his heel
bone and the infection had ‘destroyed’ the pads that connect the heel pad to the heel bone. She said there was a
‘remote possibility’ of amputation - but very remote.
He was scheduled for a second surgey on July 7th.
The assistant professor of Plastic Surgery, Dr. Brown was involved now as well as Dr. Caird.
We had the assistant professor of Infectious Diseases (Dr. Wienberg) taking
cultures and trying to identify the bacterium that
was causing the problem - so they could determine the proper antibiotics for him.
The Vancomycin/Gentomycin/Zostrin caused an acute kidney failure. So they took him off of the Zostrin.
We now had the assistant professor of Pediatric Nephrology, Dr. Kershaw and his staff working on Michael’s behalf!
July 7th.
Second Surgery. Dr. Sears came out of the OR to ask me to approve some further procedures. Dr Brown (Plastics)
was in the OR and they thought they could ‘tack’ his heal pad to the remains of his heel bone and cover the exposed
bone with ’tissue’ so that he would only need a skin graft later, instead of a muscle/skin graft.
Dr. Caird had already cleaned up some more infection and managed to ‘tack’ his Achilles tendon back to the heel bone.
I was soo happy when Dr. Brown came out after the surgery and told me how well everything went… I could have kissed him! .
Dr. Caird also came out later and told me her side of things. Everything was looking good.
The infectious disease, Dr Weinberg found out that the infection was ‘Streptococci Milleri’ , a common bacteria that
can be killed by relatively weak antibiotics, so Michael was taken off Vanomycin etc and put on Ampicillin. Because
of his kidney failure, they started him on a low dosage.
Now we spent a week while the Nephrologists tried to flush out his kidneys with fluids etc and a low sodium diet
He wasn’t eating much at this time.
They put in a PICC line so that he could get his IV, blood draws etc without needles.
More Xrays. Ultrasound scans of his heart because ‘Streptococci Millerii’ can infect your heart.
The final surgey was to take a section of skin on his groin and put it over the hole in his heel.
The plastic surgeons had managed to cover the bone with tissue, but he needed skin to complete the
process.
From the other side
Article:
http://blogs.hp.com/mckennast/2008/08/23/university-of-michigan-rules/
Here are some of the picture. Warning. gross stuff
Before images: This 'burst' at 2 am in the morning
after all the surgeries
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