Saturday started off with a lot of frustration and anger. The pain was manageable with medications, but still sitting between 7 and 10. It would settle down to about 7 until Angela moved. Then the pain would jump to 10. The teams were making their rounds, and Dr Spencer stopped by. She came in strictly to take care of Angela. She looked at the MRI and consulted with all the rest of the teams. She explained what they saw on the MRI.
There was an infection in the bone and a puss filled abscess in her stump. Because of the unknowns, Dr. Spencer said they would enter through the amputation scar and take care of it. The abscess could be filled with viscous fluid or filled with more of a liquid puss. Spencer wanted to actually cut open the leg so that all the puss and infection could be removed and flushed. Without opening up the wound, there would be no way to be able to drain the abscess with a syringe if the puss isn’t liquid.
Angela started off the day with an INR count of 3.2. It went up to 4.5 by about 9 am. Another IV was put into Angela’s arm so that she would have a faster IV to give her vitamin k. She was also given 5 units of fresh frozen plasma to help bring her INR down to 2. Once it reached 2, the doctor wanted to go ahead with the surgery. He was hoping for around noon. She finally reached 1.5 at about 1:00 pm. It was time to get her moved to pre-op.
Down in pre-op, we waited for everyone to get ready. Dr. Spencer explained what her plan was, and showed us where the incision and procedure would be, and what would happen. They planned on taking multiple cultures throughout the surgery in the hopes that they can find an aggressive antibiotic for the infection. The whole operation was only supposed to be a couple of hours at the most. I prayed and with Angela, and we held each other. The anesthesiologist administered the initial relaxer, and we said our goodbyes. They wheeled Angela toward the operating room around 2:45 pm on Saturday.
After waiting for the 4Runner for over a half hour and another almost 2 hour drive back to the house in Plymouth, I finally got back to the house at around 5:15 pm. I quickly packed up some clothes, toiletries, Angela’s Kindle, and my computer. I left the house at about 5:30 to get back to the hospital so I could be there when Angela woke up. Dr. Spencer called me at about 5:50 pm to let me know that she was finished. She tried to explain what they found in the stump. There were small syringe-like bone growths that irritated the tissue, especially the masses. Any pressure would have caused very intense pain. There were also clots that Dr. Spencer removed. This is all that Dr. Spencer tried to explain to me over the phone. It wasn’t until about 6:45 pm when I was allowed back to be with Angela, and she slept for another hour and a half.
When she started waking up, the pain was excruciating. Dr. Spencer warned me that it would probably be bad until at least Monday, possibly later. She said the pain could actually be worse than the pain that brought us into the ER in the first place. It took nearly an hour after Angela was awake to get a small handle on the pain. Angela moved back to her room on the 6th floor. It took a while to get on top of the pain again, and was finally able to around 9 or 10. We learned that Angela was given 2 units of blood during the surgery, and to be on the safe side, the doctors wanted to give her some more units tonight. They decided to give Angela another 4 units of blood, being spread over about 5 hours. Starting around 11 pm on Saturday, the transfusions won’t be done until close to 4 am on Sunday.
The floor physician has come by several times, tonight. He explained to the best of his ability what his understanding of what happened during the surgery was. His understanding was that, during the surgery, there were several pools of blood where they puss was thought to have been. He said that Angela lost some “old” blood, and that’s why she had the transfusion. Something he was hesitant to go into too much elaboration on was a potential course of action depending on the severity and response of the infection in the bone. One possibility, if antibiotics don’t completely remove the bone infection is an additional amputation. That would involve trimming the bone a little more to remove the infected portion. I’m praying that this never happens. That God clears the infection in the bone and tissue and the infection dies without doing anymore damage.
I’m praying that the morning orthopedic doctors fully explain what was discovered during the surgery, what risks there are, and what treatment options are available. I feel like this is a huge mountain that we just couldn’t find until yesterday, and now that we’ve found it, we are able to finally get past it and all this pain, these setbacks, and uncertainties.