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» Thursday, December 31, 2020And the Year Came Tumbling Down
I usually write about Christmas and New Year in Holiday Harbour, but these winter dates have been no holiday for us. 2020 ended, as it has for many people, on a bad note for us. On Christmas night, James developed a fever and his left food was red and swollen. On Saturday morning I took him to Urgent Care. Of course I was not allowed in, so I went off to make some after-Christmas purchases. I wandered aimlessly around At Home (formerly Garden Ridge), found a couple of things at And That, stopped at Barnes & Noble, then came back to Urgent Care. They released James about suppertime, with two doses of antibiotics and some Tylenol3 (Tylenol and codeine) for pain. I thought this was very strange, as the last time his leg and foot looked that bad, they kept him and gave him IV antibiotics. But we ate a small meal at Panera and went home.
James seemed fine in the evening, but at bedtime when we uncovered his foot for him to wash, the foot was scarlet, swollen and angry. I was appalled. Why had they sent him home with antibiotics? He needed IV medication! I called the Advice Nurse and she said we should wait the forty-eight hours Urgent Care told us to wait and if he was worse to take him in. He did develop a temperature, so I suggested he take some Tylenol3 and see if it controlled his temperature. It didn't, but it rendered him almost totally insensible. I finally walked him to the futon in the spare room and there we stayed until he wasn't so zonked out.
The next morning James' foot looked quite a bit better—it wasn't anywhere near as red or swollen—and he had no fever. This was the first day of his vacation and he rested and I did a few of my usual Sunday chores. But by the time bedtime was back, the foot looked horrible. I took him back to Urgent Care and they kept him overnight on IV antibiotics. On Monday morning, January 28, he was transferred to Emory St. Joseph Hospital. And there he stayed for four days.
Even though the ingrown toenail I was treating since mid-month showed no sign of infection—not red, swollen, oozing pus, or any of the other signs—there was an infection, and it has turned inward. The reason James' foot was so red and swollen, and his left leg up to the calf was swollen and hot, was that the infection was growing into his bone. I am furious. If podiatry had cut the ingrown toenail when we asked about it at the beginning of December, this never would have happened.
The doctor at Emory thought James was dehydrated and started loading him with IV fluid. Plus, he has not been able to wear compression socks, as he is required to to control the cellulitis on his left leg, due to his swollen foot and leg. So wham, next his left leg broke out into blisters, including a big bottom-of-a-teacup sized blister on the arch of his foot. We had to nag them for a couple of days to just bandage the thing. In the meantime James was given IV antibiotics.
Several things bothered me about his hospital stay. I would have settled for the olden days visiting hours of two to four and seven to nine, just to get some input. He said everyone was very nice to him, but they never gave him a sponge bath, and he had to complain that the blister was leaking on the floor when he walked before they bandaged it. He wasn't sure he was getting all his medication (he wasn't). We asked them to get James an unna boot like they use at the Wound Clinic at Kaiser and put it in a pressure bandage, but instead they have just wrapped it in some zinc-impregnated bandage ("viscopaste," nasty stuff) and covered that. Since he was required to treat it once he came home, I had to learn how to rebandage it by contacting James on Zoom and watching the nurse do it. How frustrating and infuriating.
New Year's Eve they fitted him with a PICC line. This is a catheter that goes into a main vein of the heart to deliver antibiotics. On New Year's Day they will send supplies and a nurse to the house to show James and I how to give him IV antibiotics twice a day through this line until February 10! (We tried to get a home health nurse but Kaiser would not allow it because they say we are capable of doing this ourselves. They would only send a nurse if we were incapacitated in some way.) We will also have to go to Kaiser once a week to get the PICC line cleaned. Every day I will need to irrigate it, prepare James' medicine to go through the IV tube, connect it to him and let it flow, and then irrigate it again and flush it with Heparin, in the morning, and at night. And all with keeping it germ-free.
What a wonderful new year this will be! [I'm sure you don't need a sarcasm alert for that statement, either.]
Emory didn't release him until 8 p.m., what with one thing and the other, and by the time we got home we were both exhausted. He'd probably slept eight hours in the four days he'd been there and was tired out. We sat in the living room and cossetted Tucker for a while, because he was trembling at the fireworks already going on outside, but finally we got James cleaned up via sponge bath, and by the time 2021 began we were already in bed, listening to the cannonade of fireworks going on outside from various homes in the neighborhood.