Let’s talk about yesterday! And a little bit before yesterday. Its a whole thing.
There is a lot of talk of wound care in this post. NO graphic pictures. But talk. Consider yourself warned.
I’m going to aim for a somewhat accurate timeline. It won’t be perfect. Hopefully its close enough.
About four weeks ago, we got a HORRIBLE gastric bug over here. I mean, the worst of the worst. It was WILD. Once the tummy stuff was over, Brady got a really rough cold.
During this same stretch or slightly after, Brady got his first pressure sore. We’ll call it three weeks ago. The sore lives in the middle of his back, along his spine. Bradys back has changed quite a bit since he became paralyzed, and he has a particular vertebrae that sticks out more prominently. And that is where his sore is. We went to our medical supply place and got tips and supplies and I got to treating it right away. It didn’t get worse, but it wasn’t really healing.
A week and a half ago ish, I made Brady go to the doctor for his cough. We had learned already through rehab/physio that he didn’t have the muscles to help clear his cough anymore, but after trying all we could on our end, it was only getting worse. The walk-in doctor diagnosed Brady with strep and gave him antibiotics.
Last weekend, I went to change the dressing on Brady’s pressure sore and it was pouring pus. It was horrifically infected. Plus, off to the side of his back was another clearly infected site. We knew we’d see home care the coming week but it wasn’t supposed to be until Wednesday, and I didn’t have bandages big enough to cover the areas. So I sent him to the ER to get a dressing change and to check the new area of infection.
That day, Bradys antibiotic was increased to a stronger dose, as the one he was currently on was not strong enough to address these skin issues. The new area was deemed to be cellulitis.
On Monday, we spoke to Dr. Guselle about treatment for the skin issues. The ER staff had said to use compresses on the cellulitis and we kind of had to wait and see. The ulcer that was so clearly formed would either start to drain (sorry, guys) or it would stay rock hard and we’d have to take Brady in to have it drained. Dr. Guselle confirmed that the course of treatment is that it needs to drain, so to a degree, I could orchestrate that.
Over the next day or two, we worked at it and it started draining. More than we were ready for, honestly. It was a whole thing. But it was clearly just so so sooooo infected. The pressure sore was maintaining and healing slowly, but the ulcer was worsening quickly. Dr. Guselle mentioned the risk of sepsis and inquired about getting Brady started on IV antibiotics. He really didn’t want to go that route, being that he would see home care the next day. We agreed to wait until the next day and see what the nurse would say.
On Wednesday, home care met Brady at work and she agreed that he had a solid infection brewing. She wrapped him up good and proper, and traced around the red swollen spot. He and I both knew it was growing, but we followed along with the plan. Home care arranged to meet him again at work the next day. He was starting to fever, though.
Which brings us to yesterday. Brady woke up totally lethargic and feverish. He tried to get up and go to work but it just wasn’t going to work. He couldn’t safely drive to work. He went back to bed. Home care came mid-morning, took one look and said YES to IV antibiotics. She said just looking at his body, it was clear it needed help healing. She instructed him to spend the day in bed, watching Netflix.
So, he tried, but radiation was later that morning. So we got in touch with Dr. Guselle and the back and forth began! She began calling around to try to secure Brady IV antibiotics at home. With that, we needed training, and prescriptions, and it needed to happen quickly. Radiation happened at the Cancer Centre off of RUH. The prescriptions had to be picked up from City Hospital. And as you all know, we don’t live in the city. So we kind of needed it all to happen at once. At least Dr. Guselle was determined to make it happen. We didn’t know yet where training would happen, either. So we went in for radiation and were instructed not to leave the Cancer Centre until we knew what was coming next. So we did that.
Dr. Guselle was hoping that someone at the Cancer Centre would be willing to do a little bit of the work, like the IV, or a swab of the cellulitis. No dice. Rather, we were sent to City Hospital, where the Home IV Antibiotics Clinic was located. So we did that. He went to admitting and got registered and everything.
And we waited and waited and waited. We tried to ask people who worked in nearby areas and no one knew anything about the clinic. I called switchboard and asked to be connected to the clinic, but we just heard the phone ringing behind the door. We told Dr. Guselle, and she tried to call around as well. I called switchboard again and was directed somewhere wrong, but that person made calls on our behalf as well, trying to help us sort the mess out. I called the Home Care clinic on Idylwyld, and they basically said something was amiss and they would call us once it was worked out. We just needed to wait.
Cher has been home with the babies all this time, and it was coming to the end of school. My mom joined her, as eight people is a lot of people 😅
Brady called back after that call quite quickly, and asked if we could possibly have our training at home. They said no, unfortunately the first dose HAD to be done in hospital in case there was an anaphylactic reaction. We had to wait.
Moments later, they called and said someone would be there in about a half hour to an hour. So an hour sooner, possibly.
She finally came, and she was uuuuunhappy to be there. She didn’t know the code for the door. Couldn’t reach anyone. Didn’t have the meds. She was quite obviously scattered and not happy to have extended her workday. We thanked her profusely, and she said the right things. All was well. We finally got into the room. Someone came with the meds. We had everything we needed to start.
She informed us that she absolutely didn’t have time to train us, but that she would administer the first dose for us, and home care would teach us the next day. Totally fine with us, we said! We were just grateful to get things going. The infection had long since grown outside the traced lines on Brady’s back, and we needed things to start improving. She told us she would explain as she went, but that the real training was to be the next day.
But as she worked, and we received, she started handing me things and having me do parts of the work. Which I loved! There was a lot of rollover with tube feeding, so it all made very logical sense, and I think the nurse saw that it was familiar.
The IV meds drip slowly, so we had about 15 minutes to sit and wait for the treatment to finish up. In that span of time, our nurse warmed up. We talked about cancer, fostering, dark humour, and her work. She said she has a ton of compassion for people with cancer, as she had encountered many through her job with home care. We had some laughs, and we commiserated on a handful of things.
Once the meds were done, she had me stop the drip and walked me through the disconnecting and finishing of the line. She said we were really natural with it and it would be easy after that. So there is still full teaching on its way, but the crash course provided a lot of confidence.
We finally started heading home. I had cancelled a foster visit, because there was just no way we would make it. We stopped by Brady’s work and I ran in for his laptop, since he had a couple things that had NEEDED doing that day. I updated a couple of the guys from work who inquired about him, and everyone agreed that he needed to take time to heal. It was really nice and homey there. It always is.
On our way home from work, our doctor texted “Please tell me someone swabbed your cellulitis.” No one had. We said home care could likely do it the next day, but she asked if we could come back instead.
So we did that.
We met their nurse out in the parking lot, and she swabbed Bradys infection. This was important because knowing exactly what bacteria is growing will solidify that Brady is on the right antibiotics. If there is something weird in there, we need to know about it. So, the swab was done, and we finally went home.
It was a long day. We were tired.
We whipped up a big batch of scrambled eggs and bacon, and everyone tucked into the living room for a movie. Thats all we were up for.
Naturally, the IV came out that evening. It was much to close to his elbow, being that he wheels his chair all day long. But thats ok. Another nurse will be here in the next hour or so, and she will place a new one, do the final training, and get the next dose going.
One dose per day for five days. And by then, this mess should be rectified. Or at least well on its way.
Prelim results say NO sepsis, which is a HUGE answer to prayer!! Brady is not out of the woods yet, but he’s heading in the right direction at least.
We are tired. But encouraged. We finally have the big guns drawn. Healing should be on its way.
Good thing I never gave back our IV pole from tube feeding days. Who knew we’d need it again?!