Taylor's miracle ~ Part Two

We arrived at the emergency room before sunset on Mother's Day Sunday, May 14th, 2006.  Once registration was complete, we were relieved to learn the doctor I spoke with over the phone had called the hospital and they were awaiting our arrival.  

As luck would have it, a resident orthopedic doctor assigned to Taylor’s orthopedic surgeon was on duty that evening.  He was paged to report to ER.  When he entered our ER cubicle, he remembered us immediately having assisted with Taylor’s ACL surgery the month prior.  He too had an ACL reconstruction surgery while in college and had shared his reassuring personal experience with us just before Taylor's surgery.

After the brief reintroduction, the room grew serious as he assessed Taylor’s painful, swollen knee and asked many questions.   As Chris and I suspected, it was necessary to withdraw fluid from the knee for testing.  The resident doctor inserted a long, thick needle into Taylor’s knee and extracted a yellow, bloody liquid into the large syringe.  It was horribly painful and Taylor yelled in pain numerous times as the doctor performed the excruciating procedure.  Chris and I knew the painful procedure well from previous knee injuries Chris endured many years earlier.  Yet knowing Taylor’s fear of needles, we didn’t dare mention the likely possibility of this procedure on the way to the hospital.

After waiting for what seemed like forever, the test results finally arrived and confirmed our worst fear. Taylor had developed a staphlacoccas auerous infection inside his left knee joint. The source of the infection was silently pondered by Chris and I, but no one, including the doctor, uttered a word.

The doctor ordered overnight hospital admission to begin immediate treatment for the aggressive, powerful infection. He assured us he would discuss the case with Taylor’s orthopedic surgeon who would meet us in the morning during hospital rounds. Our minds were whirling and we were unprepared for the hospital admission and frightening diagnosis.

Taylor had no more recovered from the distress of the fluid extraction, when he heard the doctor instruct the ER nurse to install an IV before moving him to his room. Panic overcame him as he faced one of his biggest fears. Chris assured him the IV was a “piece of cake” as compared to the pain of the fluid removal he just endured.

Unfortunately, the nurse must have been new and had difficulty inserting the IV. After asking us to leave the room, she closed the curtain around the bed while we waited quietly outside the door. As she attempted several more times to insert the IV, we heard her say, “I’m so sorry, I can’t get this to work. Let’s try the other arm.”

Many more minutes ticked by with failed attempts until finally she opened the curtain and told us, “I’m so sorry, I just can’t get the IV inserted in either arm. I’ll call for help.” We rejoined a pale, distraught Taylor who was fighting back tears as the nurse left the cubicle to call for assistance.

Minutes later, a very pretty paramedic from the helicopter medi-vac unit arrived at Taylor’s bedside. Dressed in a slim, blue, medical flight jumpsuit and soothing voice, she immediately put Taylor at ease. Within seconds, she successfully installed the IV with angelic speed and efficiency and just a tiny sting.

As we waited to be assigned a hospital room, a phone call was made home alerting our oldest son, Ryan, we would be spending the night in the hospital.  He agreed to look after our youngest, 12 year-old son, Austin.   We were finally settled into a room on the pediatric floor around midnight when Taylor received his first IV antibiotic infusion.

Chris and I stayed overnight in his room and took turns sleeping in the reclining chair beside his bed while the other slept on a couch in the pediatric waiting room.   We both wanted to be there for the early morning hospital round by Taylor’s orthopedic surgeon.

Early the next Monday morning, the orthopedic surgeon arrived to see Taylor. It wasn’t until the surgeon expressed surprise about the late development of the staph infection, did we recall the razor blade cut the week prior. The doctor explained that if a surgical staph infection occurs, it generally is within a week or two of a surgical procedure. Taylor’s infection occurred a month after surgery and his healing and recovery had progressed uneventful. We will never know the true source of the infection. It could have been from the ACL surgery or the razor blade cut a month later.

After looking over the extremely swollen, painful knee, the doctor requested permission for surgery to drain and wash-out the knee. Later that day, the surgery was conducted and about an hour later, the surgeon joined us in a tiny conference room for discussion while Taylor re-cooperated in recovery. 

First, the orthopedic surgeon stated he drained nearly one liter of fluid that had accumulated in the knee. Then the infected joint was washed-out and two temporary drainage tubes were inserted. His leg was heavily bandaged in thick padding, gauze, and an exterior wrap from ankle to thigh which made his leg appear twice its normal size. 

The doctor stressed the importance of keeping the leg completely straight on the flat surface of the bed which would eventually become very uncomfortable in the days ahead. If the leg was propped on pillows for comfort it could cause the knee to naturally bend. With the leg immobilized, a bend in the knee could cause it to “lock up” in a bent position resulting in extremely difficult and painful rehabilitation later and possibly some permanent disability with range of motion. 

Next, the surgeon said he had assigned a pediatric infectious disease doctor to assist in Taylor’s care. His expertise was critical for the administration and monitoring of the IV antibiotics required to combat the stubborn staph aureous infection in the days and weeks ahead. 

Later that day, the infectious disease doctor stopped by Taylor's room to meet us and ordered the installation of a long-term IV pic line. The pic line did not need changed every few days like the more common IV’s the flight nurse installed and could remain implanted for months. Using a sterile bedside surgical procedure and localized numbing, a thin, long tube was inserted into a vein in Taylor’s upper arm via a small incision. The tube traveled through his upper arm, chest and into his heart for direct antibiotic infusions. A port was attached to the tube at his upper arm location so the IV meds could be administered. Blood draws for weekly lab tests could then be taken from the pic line port. Taylor appreciated no more needle sticks for the frequent blood draws and for once, was grateful for the specialized IV pic line.

As hours turned into days, Taylor continued to battle extreme leg and knee pain and high fevers as numerous IV antibiotics were introduced and their dosages strengthened to combat the fevers. By mid-week, we were told that Taylor was being given the most powerful IV antibiotic known and if it didn’t succeed in attacking the infection and reducing the fevers, there was nothing any stronger to try. The possibility of losing his leg if the infection could not be quickly controlled was silently pondered by everyone.

I continued to stay with him day and night at the hospital to help keep his spirits lifted and sooth his fears. We played cards, shouted answers while watching the Game Show Network on TV, and talked about anything interesting to a teenager to hold on to normal thoughts.

Meanwhile, Chris worked back home and visited each evening bringing me a change of clean clothes day by day. We always kept hope his fever would break and we would go home that day or the next.

By Friday, his leg pain and fevers were still not improving. He had eaten very little all week as just the thought of food made him nauseous. He was getting weaker by the day as he struggled to endure the pain, fevers and fear.

It was decided surgery was necessary once again to drain fluid, re-wash the knee and insert additional drainage tubes into the joint in hopes of gaining control over the infection. This time after surgery, the surgeon gave some encouraging news. He said the knee looked much better inside than it did four days earlier. He drained very little fluid amounting to only about two small capfuls and the ACL graft looked good and healthy. He said Taylor probably didn’t need this final re-wash surgery, but it was good to get inside the knee again and take another look since his fevers were not subsiding.

The infectious disease doctor, however, was not convinced. He began consultations with the orthopedic surgeon about possibly removing the ACL and the screws and pin. He felt Taylor’s body could be rejecting the implant. It was the next option both doctors discussed with us if improvement was not seen soon.

The next 48 hours, however, were encouraging. The week-end had arrived and family and friends were visiting which greatly lifted Taylor’s spirits. They brought gifts and signed baseballs from the Senior League teams back home. His friends sat on his bed laughing and joking and spent the afternoons with Taylor playing video games on the Playstation supplied by the hospital. It kept Taylor’s mind off the fear of losing his leg.

During the weekend, his fevers began slowing subsiding and the leg pain was beginning to ease a bit. The doctors, however, would not release him from the hospital until he was fever free for 24 hours. It took several more days, but after a nine day hospital stay, Taylor was finally released to go home. But the battle was far from over.

Twenty-four hours fever free did not mean infection free. Being fever free for the first time in 9 days was simply an indication that the antibiotic was beginning to conquer the infection. The infectious disease doctor ordered Taylor to remain on the highest powered IV antibiotic infusions every eight hours at home for the next 4 to 6 weeks.

Prior to discharge, the hospital made arrangements with a home healthcare organization and nurse to coordinate with our arrival home a few hours later. The nurse brought several days of medications, supplies, an IV pole and an IV pump/monitor. A weekly delivery truck would begin delivering boxes of supplies and meds a few days later to our home requiring room in the refrigerator for each weekly shipment of nearly 30 pre-measured IV bags of antibiotics and other medications.

I was also taught a crash nursing course by the healthcare nurse on how to administer Taylor’s medications and IV infusions every 8 hours. She taught me how to sterilize and flush his IV pic line so it would not clot between treatments, how to set up the computerized IV pump monitor for each infusion and troubleshoot if dangerous air bubbles occurred in the IV line. It was a lot to take in and remember.

The first night home was challenging and stressful. The IV monitor alarm went off alerting us to air bubbles in his IV line during an infusion. It was 2:00 A.M. and I carefully tried to clear the bubbles as I was taught, but it was not working and the alarm continued to wail. I anxiously dialed the nurse’s cell phone number she had given me earlier. After waking her up, she kindly and patiently walked me through procedures to clear the bubbles from the line, restart the computerized infusion and silence the alarm.

Life at home settled into a mini hospital unit. Since climbing stairs was difficult for Taylor, we prepared a bedroom for him on the first floor of our home. It was much easier for visiting friends and the weekly health care nurse.

A very close eye was kept monitoring his temperature. When first home, we took his temperature every few hours. The doctors told us if his temperature reached 101 degrees, they wanted to be called. Taylor learned to hate the thermometer. It was always the indicator if things were okay or bad and he dreaded the thirty second wait for the digital confirmation.

Soon, timely schedules, routines, and journaling were established for IV infusions, vital measurements, home nursing visits for weekly blood draws and lab tests, as well as physical therapy and doctor appointments. Meal planning was also challenging to encourage the return of Taylor’s appetite. He had lost over 10 pounds off a thin 135 pound frame and his appetite hadn’t yet returned.

After missing another two weeks of classes, Taylor, still pale, weak, and thin was anxious to return to school. He was a good student and wanted life back to normal as much as possible. The doctors agreed he could return to school for the last 8 days in June of his eighth grade year. Faculty and students were happy to see him back and helped him finalize his year-end schoolwork while working around his short absences for his IV treatments at home a few blocks away.

A memorable highlight occurred during the year-end award ceremony for eighth grade graduates which was held a few days before school ended. Taylor was honored with the prestigious Merit Award Medal sponsored by the Kiwanis Club. It was presented annually to an outstanding 8th grade boy and girl as a distinctive honor towards the end of the award ceremony.

All teachers voted on the special recipient based on year round effort, participation and citizenship. Parental tears of joy and pride were streaming as his name was called among a hushed audience awaiting the special announcement. He slowly hobbled up the stairs to the auditorium stage to accept the award amongst cheers and applause from his classmates, faculty and parents.

However, unbeknown to everyone, trouble was brewing again and Taylor would not finish the last few days of school.

                                       **** to be continued ****

Grace is the power of the Holy Spirit coming to us freely, enabling us to do with ease what we could never do on our own."     ~ Joyce Meyer