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Old 01-19-2008, 10:57 AM   #1
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Infection is back - possible osteomyelitis or septic joint

The following is a very long thread - sorry. If you are already familiar with my story you could probably just jump to the questions. I would appreciate some help!

I stopped the antibiotics for my infection almost three weeks ago. The ID dr said the infection was probably gone. The only way to really know for sure is to stop the antibiotics and watch for symptoms to return.

Well, this past Sunday morning I woke up with the most terrible pain in the top of my foot and my toe. It was a very deep ache in the bone and a shooting pain that brought tears to my eyes. My ankle started acting up as well. I thought for a little while that maybe I had just overdone it the day before. I took my pain meds and elevated it for a few hours. It continued to be very painful through the morning and afternon, but finally by 10:00 at night the pain was under control. Through all of this my foot/toe was very red.

When I woke up Monday morning it was extremely difficult to walk.. Also, the redness was still there and little bumps were starting to show. It was very sensitive to the touch in a specific area close to the incision site. Of course, being 8 weeks out from my bunionectomy, the incision is healed. I didn't have a fever, but then again, I never have a fever. I about jumped through the roof when I dropped a small, mostly empty pill bottle on the sensitive area of my foot. This was the last straw for my husband who made me promise him I would call the dr when I got to work.

The surgeon was in surgery Monday, was in surgery, so his nurse called the infectious disease office to see what we should do. The ID dr said he wanted to see me right away that afternoon. I went in and he looked completely perplexed. He confirmed the symptoms were due to the infection. He took a long time reviewing my file before he answered my question - Why is it back? He said it was one of a few possibilities - it may be in the bone (we couldn't do the necessary MRI when the cellulitis was diagnosed because I had metal pins in my toe) - it may still be in the joint and the antibiotics just didn't get to it - there could be some puss or an abscess that needs to come out - or plain and simple we just didn't do the antibiotics long enough. He scheduled an MRI for the soonest possible date (Thurs noon), had his nurses place a picc line, start the vanco, and told me to get in to see my ortho surgeon as soon as I could.

I saw the ortho Tuesday. He looked like he was troubled by the return of the infection. After taking some xrays, he said clinically I looked good which is to be expected since I had already started the vanco - although it was still very sensitive and painful He had his nurse call all over the city to find me an MRI appt before Thurs. He really wanted to have it done yet that day, but couldn't find a place. He assured me that he was all over this and was going to do everything he could to figure out what was happening and what we were going to do about it. He said he would read the MRI report and then call the MRI office and talk with the person who wrote the report to discuss the results in the context of my history because sometimes that makes a difference. Also, there is a possibility that my most recent surgery can impact the result of the MRI and produce images that look like osteomyelitis. He said a negative MRI could tell us more than a positive one. If it shows there is an abscess left in there we will need to drain it.

I went to the MRI Wednesday night (dr finally found a place to do it sooner). I can't help it, but I was actually imagining little circular cells with neon blue dye in them jumping up and down shouting, "Here we are - Over here - See us?" It may sound like I am hoping I have an infection in the bone, but that's not the case. I believe it is in there because it came back just 2 weeks after we stopped the anitbiotics and the pain Sunday morning was a deep bone ache. I just want a definitive answer. I really want them to tell me why the infection has returned and what we are going to do about it. If there is an abscess that we could drain, that would also be clear and definitive. However, if they just say they don't think it is in the bone, and they don't think there is an abscess, they just need to do the antibiotics longer I think I am going to scream!!!!!

The ortho nurse called late Thursday afternoon to tell me the dr is going to have another radiologist read the MRI report. He was not impressed because the report states there is infection in a joint I don't have anymorme due to my most recent surgery. I am a little confused by that because I didn't think we were fusing anything when we did the Keller Procedure. Has anyone else fused their toe through the Keller? Besides that, the report states the infection is definitely in the bone and surrounding it - possibly even in the second toe. I am not convinced this is true yet, since dr is having someone else review the film. I hope to know more Monday, but it may be Tuesday by the time I hear anything.

Questions:
Does anyone else have experience with osteomylitis? How about with it returning? How about a septic joint? I would like to hear from someone who had osteomyelitis and did not have surgery to treat it.

I just have to say I am really tired of being sick. This saga has been going on since July of 2006. It causes me a lot of stress, especially at work. As a matter of fact, my performance has really been suffering at work and I do not like that at all! I am wondering if there is something bigger wrong with me that is behind all of these infections - or is it one infection that keeps flaring up again???

Any answers or encouragement is appreciated. I am sorry this post is sooo long, but I had a lot to get off my chest.
Thanks!
Step

 
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Old 01-19-2008, 10:03 PM   #2
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Re: Infection is back - possible osteomyelitis or septic joint

I'm so sorry you are still struggling with this. I don't have any personal experience, but, yeah, bone infections are extremely hard to wipe out completely, especially with the pins and whatnot leaving you open.

Just keep hanging in there, try to keep laughing, and eat as healthy as you can. It won't cure the infection alone, but the antibiotics need all the help they can get, right?

Here's hoping you get some good answers soon.

 
Old 01-22-2008, 03:47 PM   #3
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Re: Infection is back - possible osteomyelitis or septic joint

Thank you very much Jane. I appreciate your encouragement more than you know. I am really getting down lately. I am so tired of being sick and in pain. I have grown even more tired of not knowing why this infection keeps coming back. I have been waiting for my doctor to have someone re-read the MRI since last Thursday. He seemed to be all over it last Tuesday when I was there, but now I have left three messages over the last three days and nobody has even called me back. All I can say is ARRRRRRRGGGGG!!!!!!

Anyway, I a going to lay down, put my foot up, watch some funny t.v., take some pain pills and go to bed.

Step

 
Old 01-23-2008, 03:46 PM   #4
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Re: Infection is back - possible osteomyelitis or septic joint

All I can say today is double ARRRRG! The dr finally called me. He said the radiologist that he wants to "over-read" the mri films is out of town until Monday, so we won't have his thoughts on it until next week. We hurried to get the MRI done, so we could wait... Anyway, he is still unclear about anything, but he doesn't think it will require anymore surgery.

This is good news, but in a way I feel disappointed. I really wanted to have an answer for why the infection returned and a solution for all the pain. My forefoot hurts worse today than it did last week. I am really frustrated and feeling really down.

So, I am only going to work half days and begin wearing the air cast again. Hopefully it will help my foot to be a little more comfortable. We will continue with the antibiotics and see what the other radiologist says.

Step

 
Old 01-24-2008, 12:44 PM   #5
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Re: Infection is back - possible osteomyelitis or septic joint

Step, I can believe what you are going through, It's a total nightmare, I don't know how you are coping, but I admire your strength, I'd be a total wreck. I am glad to hear that you won't have to have surgery again, but I hope the treatment will be gentle. I can't wait for you to recover, I am lost for words. Infection is a nasty thing t suffer from, especially if you are in pain. Your sugeon seems caring enough, I hope he returns soon so you can get some answers and started with your treatment. Good luck, I will check back to see how you are getting on.

 
Old 02-23-2008, 03:23 PM   #6
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Re: Infection is back - possible osteomyelitis or septic joint

Hi Steph,

I was wondering how you are recovering and I am hopeing your infection has cleared.

Hope all is well

 
Old 02-24-2008, 06:15 PM   #7
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Re: Infection is back - possible osteomyelitis or septic joint

Hi Dark Light,

The Dr finally decided the infection was actually in the bone. I don't know why it took so long for him to be convinced, but it was two and a half weeks after the MRI before he finally said it was in the bone.

Good thing the Infectious Disease Doctor was already treating me with strong antibiotics. I have been taking Vancomycin for 6 weeks now, so I will stop taking it tomorrow when they remove my picc line. I can't wait! However, there is really no way of knowing the infection is gone for sure. Usually, six weeks on the antibiotics is enough, but you don't know until you go off the antibiotics and see how it goes.

So, starting tomorrow, we will be watching my foot carefully to see what happens.

I appreciate your concern, and I hope things are going well for you.

Step

 
Old 02-25-2008, 01:35 PM   #8
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Re: Infection is back - possible osteomyelitis or septic joint

Hi Step!
Sounds like some good news to me, I am glad they have found out where exactly the infection is, but I am not too happy it has taken them this long, if I am correct, you had it in your bone last time, so I thought they would've checked that area first.

I am glad you are feeling excited and I hope the infection is gone for good. I wish you the best of luck, Please let me know how yu get on.

As for me, that small infection I had on my incision which was considered superficial, has made my scar look very ugly, but it's the least of my worries. I hope my toe begins to feel normal, I am to have my other foot done on 20th March.

Thank you and good luck

 
Old 02-25-2008, 06:16 PM   #9
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Re: Infection is back - possible osteomyelitis or septic joint

Wow! You are going to have the other foot done too? Well, at least you know what to expect this time.

Best of luck and keep posting, so we know how things are going for you.

Step

 
Old 02-25-2008, 11:38 PM   #10
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Re: Infection is back - possible osteomyelitis or septic joint

Hey, Step,


I am glad they are trying to make sure you stay well and the infection is gone, but I continue to think that the bone scan with cipro is a simple way to know for sure if the infection is gone from the bone or not, and I am not sure why doctors don't use it more. Could you ask your infectious disease doctor about that? It might be a good way for you to find out it really is gone. In my case, I had infection in my lower jaw in 2005--and I have a bone scan, not with cipro, just a regular one, that shows inflammation in the lower jawbone. I have bone scans now, one with cipro, that show infection in both sides of my upper jaw, and the regular bone scan shows inflammation in the lower jaw a bit, but the cipro just shows up in the upper jaw, which shows that the infection was cleared out with the surgery that I had two years ago on the lower jaw.

I hope this helps a bit. I am at least happy to know that the surgery did work on my lower jaw with a bone scan as well as the fact that my symptoms disappeared in that jaw, and it gives me hope that the same can happen with my upper jaw and I can be well again! I am definitely using your info about the 6 weeks of vanco if they do surgery finally, because everything I have found says it is the best follow up treatment after bone infection surgery.

I hope the best for you.

Beth
[QUOTE=stepbystep89;3456822]Hi Dark Light,

The Dr finally decided the infection was actually in the bone. I don't know why it took so long for him to be convinced, but it was two and a half weeks after the MRI before he finally said it was in the bone.

Good thing the Infectious Disease Doctor was already treating me with strong antibiotics. I have been taking Vancomycin for 6 weeks now, so I will stop taking it tomorrow when they remove my picc line. I can't wait! However, there is really no way of knowing the infection is gone for sure. Usually, six weeks on the antibiotics is enough, but you don't know until you go off the antibiotics and see how it goes.

So, starting tomorrow, we will be watching my foot carefully to see what happens.

I appreciate your concern, and I hope things are going well for you.

Step[/QUOTE]

 
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