Facebook keeps showing me memories of late June hospital stays from the past few years. It’s funny, Grace does tend to be hospitalized at the same time of year over and over again. Last year, it was her knee. We spent 4th of July in the hospital last year; I watched neighborhood fireworks from the hospital window and ached to be with my son and husband. The year before, the year we went to Tahoe, she had MRSA in a finger. That was a hard infection to treat. A couple years before that, she had exposed bone for one of the first times.
Today is the last day of June, and we are not in the hospital. YET.
Gracie broke her arm a few weeks ago, and it has been in a removable (bivalve) cast. I am scared to remove the cast. Her arm is not terribly stable, and the cast is hard to get off, so it’s a nightmare to wiggle the cast off while trying to hold her arm still and not yank too hard. I’ve only been checking it once a week—each Wednesday.
The first time I checked it, there was a pressure sore over her index finger knuckle. Chad dremeled out the cast, I padded it, and we wrapped the arm back up again. I checked it again last night.
The original pressure sore was not bad, but there were other sores over her other knuckles. Her arm was quite swollen, probably more than it had been the previous week. She had deep red streaks down the swelling, as if the padding at the seams of the cast was pressing too hard on her arm. They were the beginnings of massive pressure sores. I called her ortho doctor, not sure what to do. She suggested that I could bring her in to get a new cast, and they could cut it in a different spot so that I can switch them, thereby reducing the risk of pressure sores. It was actually a great idea. We scheduled an early morning appointment for today.
On our way into the ortho appointment, I saw one of the PAs we’ve seen repeatedly at the hospital, E. He is great. I waved to E as we walked by for our casting appointment with the tech. When I took off her cast for the tech, the knuckle sores were not bad – not red at all, and really quite tiny. Her arm, though, was still red and swollen right above the break. Hot, red, and swollen.
The tech remarked that maybe the cast had made the arm hot. She crafted a new cast for Grace, one that will give her more finger movement and also has more padding. She cut it on opposite sides from the other one, so that the padding will not rub in the same spot when the casts are exchanged. She took the cast and left the room so that she could put felt tape over the cut sides and velcro straps around the middle.
Sometime during the appointment, the gears in my head started turning. Gracie has been off for the past few days, acting like she could have an infection. She keeps wanting me to take her temperature (usually a sign she feels like she has a fever), she’s not eating all that well, she’s lower energy than usual. She has a few cuts here and there across her legs, but nothing that looks terrible. Except the arm.
When the tech returned with the newly bivalved cast, I asked her the question I dreaded: “Could it be infected?” She stopped—”I—I don’t know. Let me get E.” Thankfully, the clinic wasn’t too busy this morning. E was in there within minutes. He felt the arm, felt the heat around the break, saw the redness. He agreed, it looked a little infected. He remembered that we’d spent holidays in the hospital before, and didn’t want that for us this year. He prescribed her an antibiotic. Not the very expensive one that requires pre-approval, but one that has worked for her mild infections in the past. (Notably, it hasn’t worked for the more severe ones…)
She’s had two doses now today. I will have to wake up overnight to give her the third. We will have to wait and watch—I will have to check her arm every day until the infection starts to clear. I am worried, so worried, that the infection is in her bone. If it is, she will undoubtedly have to head to the hospital after the holiday weekend, may need surgery, maybe even worse. This antibiotic may buy us some time, but it won’t cure a bone infection. Not in ten days, at least.
Here we go again.