Okay, here's another update. It's a bit after the fact, bear with me.

So, to recap, on Feb 14 I finally got the antibiotic spacer removed after living with it for 3 months and functional hip hardware re-implanted Things were going great…I was back in physical therapy and regaining strength and mobility quickly. That’s about where we left off last time.

The dressing over the incision was hooked up to a small wound vac that I was supposed to wear for one week after being released from the hospital. Almost nothing drained from the incision into the wound vac until the day before it was supposed to come off. Then a bunch of “old” blood drained out and nearly filled the vac’s reservoir overnight. I called my ortho and they got me in right away…the drainage had stopped by then and he figured it was just a clot that had liquefied and drained. He considered putting another wound vac on with a new dressing, which I wasn’t very happy about. I was trying to get back to work and that’s not very easy if you have to drag around a bunch of post-surgical devices with their associated tubes and hoses (and this was also on a Friday afternoon and getting insurance approvals for another device wasn’t happening quickly on a Friday afternoon). Since the drainage had stopped, they re-dressed it with a bunch of gauze and tegaderm and I was to let them know if any drainage resumed.

Things went well thru the weekend until the following Tuesday (3/27) when, after a morning PT session, a bunch of new drainage occurred. Not blood this time, but a tannish fluid…and a quite a it of it, the gauze became saturated. I called and then texted a picture of the gauze to my ortho’s PA. They called me back right away, asked when I last ate anything and wanted me to come in for a “wash-out” surgery in 3 hours. Calling that a shock doesn’t really describe it…I guess the drainages I’d had were a clear sign something wasn’t right, but it’s hard to mentally prepare yourself for surgery and all that entails on such short notice.

So, I go in and do the wash-out that day and was put on IV antibiotics. I expected to stay in the hospital for another 2-3 days after surgery while they fine-tuned the antibiotics dosage. Two days later, my ortho tells me a culture they took during the wash-out was growing something but it probably would take another day until it grew enough for them to identify it. Throughout all the previous tests and cultures, they had never been able to successfully culture anything from my hip, so it was kind of a positive that they might finally know what, specifically, had been causing me all these problems.
The next evening, the ortho and my infectious disease specialist come into my hospital room to let me know the culture produced staph (not mrsa) and they were recommending yet another surgery. He said the chances success from the wash-out surgery I had just gone through and antibiotics was somewhere around 50-60%...if I agreed to one more surgery to swap out the hardware and continued antibiotics, we were told the chances of success went up to nearly 90%. I was really weary of another surgery (one week exactly after the wash-out), but the increased chances for success were pretty striking, so with my wife we decided to follow their recommendation. This was going be the 5th overall surgery on my right hip, and it would be surgery #4 since just last November, and a 3rd surgery in the span of just under 3 weeks. They made me stay in the hospital thru the weekend until the next surgery. That was a tough time; there was a lot of frustration, anger and tears.

Tomorrow marks 2 weeks since the most recent surgery (which was on 3/6). I’ve got a PICC line (again), giving myself cefazolin infusions three times a day, and taking rifampin capsules twice a day.

I’ve re-started PT once again, and I went back at work last week (6 days after surgery). It’s frustrating to have put in so much work to regain mobility just to have more surgeries kick me back down again. No more surgeries scheduled as of now; just waiting to see how this course of antibiotics goes. I need to talk with my infectious disease specialist again because I want to better understand his plans…what is he looking for in my weekly bloodwork? When does he anticipate discontinuing the antibiotics? What’s the plan after ending the antibiotics--hopefully not just “wait and see". What more can they/we do to make surer this treatment actually works?

Jump to this post