Home at last?

I’ve been missing in action for most of January. Following the blood thinner hassles around Boxing Day, I caught some bug that attacked my left hip on 7 Jan. So before I could blink, I was back in hospital.

The usual ED blood tests indicated my old friend staph epidermidis, also present last October in my right hip. The usual treatment is 6 weeks of Vancomycin, which began immediately.

Over the next two weeks, I was discharged twice, followed by two re-admissions due to more infection and for low HB.

(One excellent thing that happened during one of those snap home visits was that Julie disappeared and returned with one of those electric easy chairs. With the help of relatives and friends, she unboxed it, plugged it in and I’ve been nestled it almost every waking moment since. Now I’ve just go to work out how to stop the grandkids fiddling with the control – especially while I’m in it.)

Back in hospital, ultrasounds, scans, and eventually an MRI found several pockets of some kind of fluid in my hip (maybe pus?). However, no-one could decide whether to drain or cut open my hip to get rid of it. Eventually, I had a needle inserted to draw out the fluid (aspiration). Not much fluid. Next, I had a drain tube inserted to try a slow drip release. Again no joy, and it fell out after the second day.

Around now, at last, a senior Infectious Diseases Consultant decided to look hard at my history. She found that this was the same bug going back to 2012. It seems that while Vancomycin kills it in test tubes, it doesn’t in my body. So she changed to a new antibiotic (Linezolid) which should polish it off after 6 weeks. Once that’s done, I’m to take another antibiotic for the rest of my life as a prophylactic, designed to stop any further infection before it begins.

Once all this was decided, four weeks after I arrived, I was released home on Feb 3.

I can’t say I’m better yet. Still limping and collapsing after the smallest effort. But there is progress. Yesterday Julie and I went out for coffee (bliss). Who knows what madness could follow over the next few weeks?

Which is important, because the infection is just a sideshow. The main game is my heart and the 90% blockage in my right coronary artery. And for the last few weeks, my AF.

So far, I’ve had three plans for going forward: all involved two specialists grinding down the blockage and putting in a stent.  Each time this has been cancelled due to my infection: I must first be infection-free. This could take another 3-4 weeks. All the time taking blood thinners to get me ready for the stent.

However, just today, my Cardiologist called to say the plan has changed. I must still become infection free, but now I need to have my AF reverted first, and then perhaps my blockage can be dealt with “medically”.

First, fixing the AF, probably by zapping. Just before the zap, I’ll have a TransOesophaegal Echo (TOE) – an ultrasound taken of the heart from the oesophagus, via the back of the throat. They are worried about the possibility of a stroke if the zapping releases clots into my bloodstream. So, if there are no clots around, my AF will be zapped. If there are clots, they will block them off from the bloodstream first. In preparation, I’m to stop the blood thinner a week before, then 3 days before onto Warfarin.

So what about the stent? Medically, long-term Warfarin may be enough to keep my blood thin enough to get past the blockage in the medium term. So maybe it can be put off for longer, unless I get angina, or fail a stress test, etc.

Next stop the TOE and hopefully the AF reversion.

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