Mrs X is a 40 y-o patient who I met in a surgical ward. She comes to hospital this time for an elective removal of bone spurs and local debridement on her left femur.
The story was: about 4 years ago she had a tiny wee spot of infection of the skin overlying her left patella (that's knee cap for you and me). Fast forward many Abx and few months later, the infection was still there- unshifted. By this time she was feeling unwell with signs of mild systemic infection- hence she was admitted to hospital for IV Abx. However- as she was feeling no better- an aspirate was done + a scan of her knee joint. The infection had spread to her joint cavity (now its about a year since first skin presentation).
So: Her left patella was removed and the joint was replaced with a spacer (p53: is it like an artificial joint, like that of a knee replacement? Mrs X: No, its just a space-filler, the knee could not bend as well. P53: ooo0000ooo *making mental note to check how does that look like/work?*)
1year post-op, she noticed pain while walking and reported "feeling a bit off". Symptomatic treatment was given and she was enlisted for care of Chronic pain team. Many neuralgic meds later, the pain persisted- now about 2 years post op. Second opinion was seeked and she was refered to Smallcity's base hospital.
After doing few more investigations, it turned out that she was having osteomyelitis then (which explain the pain and her feeling unwell). Due to the level of permanent damage of her tibia and fibula, they were removed too.
And for the first time in 3 years she felt completely well (how ironic is that being just under 40 and yet so calm/blase/accepting to the fact that she's an amputee ....... gosh, I thank God for my legs and my well being... go on say your prayers now!) and she resumed her work as an administration staff at school.
However, the happiness didnt last long (well.... I have to use one of those cliche havent I?). Roughly 6months after she felt unwell again. The osteomyelitis had spread up to her inferior end of her left femur. (So the infection had been so mild, so low grade, it had spread to a wider area unseen macroscopically right from the very beginning!!!)
She unfortunately had an above-knee-amputation. (She said and I quote: I would rather keep my life than keep my decaying parts).
Since then she had been in hospital 3-4 times for removal of spurs (even doctors dont know why they keep on coming back) and local debridement.
She is currently under the care of the Plastic Surgery team. She can walk with a prosthetic- although not mobilising at the moment due to recent surgery. Bless her. She has been through a lot and still pretty optimistic about her life.
PS: She's such a good historian!
The story was: about 4 years ago she had a tiny wee spot of infection of the skin overlying her left patella (that's knee cap for you and me). Fast forward many Abx and few months later, the infection was still there- unshifted. By this time she was feeling unwell with signs of mild systemic infection- hence she was admitted to hospital for IV Abx. However- as she was feeling no better- an aspirate was done + a scan of her knee joint. The infection had spread to her joint cavity (now its about a year since first skin presentation).
So: Her left patella was removed and the joint was replaced with a spacer (p53: is it like an artificial joint, like that of a knee replacement? Mrs X: No, its just a space-filler, the knee could not bend as well. P53: ooo0000ooo *making mental note to check how does that look like/work?*)
1year post-op, she noticed pain while walking and reported "feeling a bit off". Symptomatic treatment was given and she was enlisted for care of Chronic pain team. Many neuralgic meds later, the pain persisted- now about 2 years post op. Second opinion was seeked and she was refered to Smallcity's base hospital.
After doing few more investigations, it turned out that she was having osteomyelitis then (which explain the pain and her feeling unwell). Due to the level of permanent damage of her tibia and fibula, they were removed too.
And for the first time in 3 years she felt completely well (how ironic is that being just under 40 and yet so calm/blase/accepting to the fact that she's an amputee ....... gosh, I thank God for my legs and my well being... go on say your prayers now!) and she resumed her work as an administration staff at school.
However, the happiness didnt last long (well.... I have to use one of those cliche havent I?). Roughly 6months after she felt unwell again. The osteomyelitis had spread up to her inferior end of her left femur. (So the infection had been so mild, so low grade, it had spread to a wider area unseen macroscopically right from the very beginning!!!)
She unfortunately had an above-knee-amputation. (She said and I quote: I would rather keep my life than keep my decaying parts).
Since then she had been in hospital 3-4 times for removal of spurs (even doctors dont know why they keep on coming back) and local debridement.
She is currently under the care of the Plastic Surgery team. She can walk with a prosthetic- although not mobilising at the moment due to recent surgery. Bless her. She has been through a lot and still pretty optimistic about her life.
PS: She's such a good historian!
This is the epitome of mother of all reasons why I dont want to do Plastics. Too gruesome, too heart rending, and too surgical. haha.
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