Sunday 14th December
The previous day I’d taken my morning and evening doses of Rifamycin (600Mg) and the regular doses of Clindamycin. My stomach was still feeling iffy, but nothing dramatic.
Sunday morning I downed my pills, but during the course of the day I started to feel gradually worse. By the evening when I was due to take my last dose of the two antibiotics I felt in no state to do so, my stomach pains were so severe that I was getting quite worried and about 10pm I called 111 and gave them my symptoms.
I was advised to get down to A&E within 6 hours. I pottered about a bit doing stuff ’til about midnight, then feeling a little better I decided to get a few hours sleep if I could before going to A&E. I set the alarm for 4am and managed to get off to sleep.
Monday 15th December
Having called a taxi I arrived at A&E at 04:45. Had to wait a few hours but eventually it was my turn and once I’d explained my history and symptoms the nurse took a blood sample for immediate analysis. A couple of hours later the acute medical doctor (I think that’s how he described himself) came into my cubicle and asked me if I wanted the good news or the bad news first? To be honest, I couldn’t have cared less; this injury and infection had been dragging on for so long I was getting very weary of it. In fact, I remember at some point when the nurse and doctor were with me earlier that morning I’d choked up and couldn’t speak. I just felt like I’d had enough.
Anyway, he made the decision and gave me the good news. My infection levels were very low. Good news? I wasn’t clear yet and I’d been told before that the infection level was low. OK. The bad news? The enzyme activity level in my liver was higher than normal. Apparently, this is quite a common side-effect of Rifamycin and the doctor said he’d take me off it and the orthaepedic department would decide on a less aggressive substitute.
That was fine as I had the appointment later that morning with orthaepedics for the wound review – see, there was method in my madness for turning up at A&E at 04:45. I had three-quarters-of-an-hour to spare.
By the time the nurse in orthaepedics was ready to see me they’d already been notified of my visit to A&E and said they’d give me a prescription for Doxycycline to replace the Rifamycin. Also, they gave me an appointment for another Liver Function Test for a week later, to check the enzyme levels had returned to normal.
The nurse removed the Pico dressing and carefully peeled off the non-stick gauze layer underneath.
Now this was interesting. Never before on any of the wound dressings had I seen a black residue. All along I’d been thinking that as well as the gravel that had got into the wound, given that my jersey pockets had been full of that very fine, black, peaty soil chances are there was a whole lot of that stuff in the wound that had not seen a decent clean out until the two washout and debridement operations. Four or five times during the 2/3 months they’d been treating me they’d considered the washout and debridement surgery but not gone ahead. Now at least for the first time I felt progress was being made.
But next, I was in for disappointment. The orthaepedic registrar (a really nice guy) took a look and declared he was very pleased with the wound and there would be no need for a further Pico dressing. My thoughts were that if the Pico dressing had managed to draw out that black residue why not use another one as the last one had only been on for 4 days. Instead, they put a normal dressing on and sent me on my way having put the cast back on.