Friday, July 10, 2009

Dual Isotope Scans Completed

On Wednesday the good folk at St Charles sucked 60ml of blood out of me, separated the white blood cells, made them radioactive, then injected them back into me. Four hours later, I returned to have my leg and ankle scanned to find where the white blood cells had gone. White blood cells have a jones for infections so they will group at infected sites and the resulting "hot" spots in the scans will show where the battle between the yeast/staph bugs and my body's defensive mechanisms is occurring.

Yesterday, I went in for a second scan, this time using a different isotope that was simply injected, no blood required. After an hour they scanned me again. This particular isotope has an affinity for bone marrow.

"How does it know where the bone marrow is?" I asked.

"We don't know -- that's chemistry stuff," said the radiologist, giving me the look that people give to people who ask geeky questions.

But I got a cool sticker with the international symbol for radioactivity to wear because I was such a good patient.

The point of all this is to see whether any of the infected sites are where my bone marrow is.

Infected bone marrow bad.

I have to wait a few days for the results, I guess. Radiologists take the pictures, someone else interprets the pictures, then gives the information to the doctor who issued the order (Dr Lutz, in this case), who will presumably pass the information to the surgeon who re-built my ankle (Dr Askew), who will most likely give someone there the job of ringing me with the news.

In the meantime, the weather is great, my ankle isn't bothering me too much (although it did develop this totally gross giant pimple ick ick ick); Stage 7 of the Tour de France is waiting in the Moxi box for tonight's viewing pleasure; my son will be stopping by Pizza Mondo after work to select tonight's entrée; and we'll wrap up the evening with another DVD of his choice: House of a Thousand Corpses.

Mrs Elliott returns to Bend tomorrow evening. Sigh. My son's great, but I miss her.


  1. Really so sorry to hear you're having so much trouble still with the ankle, Jack. I'm not an MD but I can't help thinking that if proper pre-op and post-op sterilization procedures had been followed a serious infection should not have occurred. As you know I do not have a high opinion of the American medical profession in general and the Bend medical profession in particular. St. Chuck's would definitely NOT be my first choice for any significant surgery, unless it was a life-or-death emergency.

    Good luck -- and don't be afraid to give your doctors hell if they deserve it. I believe you have been badly served by our local sawbones, going back to the guy who gave you the cortisone shot that put you in a wheelchair.

  2. "But I got a cool sticker with the international symbol for radioactivity to wear because I was such a good patient."

    Wow. And who says we don't have the world's greatest medical care right here in little ol' Bend?

    Did they give you a lollipop too?

  3. We wanted to be close to home, I've had enough pain and misery in away from home these past two months, and the drive back to Bend post-op would have been really uncomfortable.

    The surgery was done at Bend Surgical Center. Nosocomial infections happen. I'm not happy about this, not at all, but there's nothing to be done at this time.

    Didn't ask for a lolly, but I always insist on stickers.

  4. "The surgery was done at Bend Surgical Center. Nosocomial infections happen. I'm not happy about this, not at all, but there's nothing to be done at this time."

    "Nosocomial" is a nifty word. So is "iatrogenic."

    As for there being nothing to be done, I respectfully disagree, Jack. There is something you can do: You can bitch. I'm a big believer in the efficacy of bitching. I think if more people bitched more often there would be less carelessness and incompetence in the world. Too many people shrug their shoulders and say "Shit happens" and just let it slide.

    I think I want to get a bumper sticker made up that says "Bark More, Wag Less."

    I had surgery done at the SurgiCenter in October 2008 and was not impressed at all. I experienced urinary retention and had to make a mad dash to BMC's Urgent Care Center that evening to have a Foley catheter put in to keep my bladder from exploding, then the next day I had to come back to have it removed. The urgent care physician tried to tell me it happened because I had an enlarged prostate. I was skeptical because I hadn't been having any previous problems and I'd had my annual physical just a few months before and the doc said nothing about an enlarged prostate. So later I saw a urologist who examined me thoroughly and told me my prostate was NOT enlarged, and furthermore that urinary retention is a common occurrence after any general anesthesia procedure and there are medications that the anesthesiologist can administer to prevent it. Evidently the crew at the SurgiCenter didn't think of it, or maybe they just didn't give a damn.

    The urologist also told me it's SOP after general anesthesia to keep the patient in the hospital until he/she can pass urine. But the SurgiCenter was in too big a hurry to shove my half-conscious carcass out the door to make room for the next vict ... er, patient.

    The trend toward doing increasingly complex surgeries on an outpatient basis is worrisome generally. The post-op care involved (wound cleansing, medication management, etc.) is often quite complicated and really requires somebody with nursing skills. Instead the patient gets sent home almost as soon as he's off the operating table and has to depend on a spouse or a friend -- or maybe himself -- to provide post-op care. This is not only hard on the caregiver, but also potentially dangerous. I'm sure your wife did the best job she could, but I have to wonder if the infection might not have happened if you'd had skilled nursing care.

    This is not the hospitals' fault; they'd love to have patients stay. The problem is that the piratical insurance companies won't cover a hospital stay for anything less than a liver transplant or a quadruple bypass (and even then they give you two nights, I think). Plus many local surgeons own shares in the SurgiCenter and get a cut (pun intended) for every operation done there. (I bet the guy who operated on your ankle is one of them. You could check it out -- they're required to disclose that information.) This is a clear conflict of interest and should be illegal, IMO.

    Re having the surgery in Portland: Yes, it would have been uncomfortable and inconvenient. But it doesn't sound like you've been enjoying much comfort and convenience after having the procedure here in Bend.

    Keep us posted on how you're doing, and good luck.

  5. Oh -- I'm bitching, you bet I am.

    I'd forgotten "iatrogenic." Excellent word.

    I've spent months in hospitals, I've been left alone in a hotel room in Mexico city with an IV drip and instructions to remove it after it was empty.

    I prefer nursing myself. Changing dressings, etc., is all part of the fun to me, believe it or not. I'm enough of a geek to get into fussy stuff like that.

    I am in agreement with my orthopedist that this procedure was a good candidate for outpatient. But I'm not real happy with the crud that got into the wounds. That's not cool.

    That said, I've had so many surgeries that didn't have complications that it's probably my turn in the barrel.

  6. "Changing dressings, etc., is all part of the fun to me"

    You are a SERIOUSLY weird dude.

    Just imagine how much fun you could have had in a Nazi concentration camp, especially if Dr. Mengele got hold of you.

  7. "then the next day I had to come back to have it removed"

    Oops, I used a pronoun without a clear antecedent. My fourth-grade teacher Miss Wilgus would be ashamed. Should have made it clear that it was the catheter that was removed, not the bladder.

  8. I could-a been a nurse. But I would use my power only for Good, never for Evil.

  9. Hey Blackdog, I accidentally pressed "reject" rather than "publish" on your last comment -- the one about the lawyers. Blogger does not seem to have a way to change one's mind about such things, so if you are bored after gardening, you might want to re-send that comment.

    But don't be mistaken by my "blogger voice" that I am taking this lightly. If a bone marrow infection, osteomyelitis, or other similar diagnoses are made I'll be looking at getting some grievances settled.

  10. "Hey Blackdog, I accidentally pressed "reject" rather than "publish" on your last comment -- the one about the lawyers."

    No problem.

    The medical profession in this country always whines about too many malpractice suits. If you ask me there are not enough. If more people got their asses sued off for medical screw-ups we might see a lot less of them. IMO.


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