Wednesday, March 9, 2011

Necrotizing Fasciitis

This post is not a happy one, I'm afraid. I'm just warning you up front, this one is going to make you squirm. But I feel the need to write this.

About a month ago, I got a call from my brother in Atlanta telling me that he was at the hospital with not one, but BOTH of my parents. My immediate thought was "car accident" and I was terrified. Turns out there had been no accident. No acute trauma. No obvious medical condition in need of treatment. My brother had simply gotten a feeling that something wasn't right. My dad was acting weird. My parents are young and active, and my dad sounded delirious on the phone. It was out of the ordinary. Thank God my brother trusted his instincts and drove over to my parents house to check things out. He initially thought Dad was having a stroke, so he loaded both my parents up in the car and headed immediately to the hospital. While waiting for Dad to undergo the requisite battery of tests, he noticed Mom's hand was swollen.

"What happened to your hand, Mom?"
"Oh, I fell the other day and I think I must have hurt it."
"Maybe we should get that x-rayed while we're here. It looks nasty."

Not 2 hours later, her swollen hand had progressed into a bruised and blistered arm. It was obviously an infection, and we later determined that it was Necrotizing Fasciitis - more affectionately known as the flesh-eating bacteria. My Dad had the same thing - his delirium was caused by a high (106 degree) fever as a result of the systemic infection.

Oddly, necrotizing fasciitis is caused by the same bacteria that causes Strep throat - group A streptococcus. A person can contract the infection through coming into contact with the Strep bacteria with an open wound. It's likely my Mom had a cut on her hand (just a little split from dry skin) and came into contact with someone carrying Strep throat. It's really uncommon for the bacteria to enter the bloodstream and frankly, Mom & Dad just got unlucky. According to the CDC, there are approximately 10,000-15,000 infections each year in the United States, resulting in 2,000-3,000 deaths.

That being said, although this infection is rare, I cannot emphasize enough how important proper wound care and other precautions are. Especially with our kids spreading around every germ under the sun at day care and school, and scratches and cuts being a part of daily life. Wash cuts and scrapes out with hydrogen peroxide, apply neosporin and cover with a band-aid. If someone in the family has strep throat, be especially diligent about handwashing. Children who have chickenpox are also at a greater risk for developing necrotizing fasciitis. Monitor open sores, cuts and scrapes and go to the doctor if the area becomes more painful, red, swollen, hot to the touch, or blisters. High fever is also associated with strep A and other infections. Specifically ask the doctor to rule out necrotizing fasciitis. Frustratingly, we later found out that my Dad had sought earlier care for the infection, but his primary care physician misdianosed the condition. Because it is so rare, many doctors miss some obvious signs.

At the end of the day (or month, as the case may be), Mom narrowly avoided surgery and is home and doing well. She continues to go to physical therapy and is just starting to drive again. Dad, however, is having a rough go at it. Surgery was required to remove infected tissue in his abdominal area. This surgery saved his life, but left him with an open wound. He is now in the ICU to undergo several skin graft procedures to repair the damage. We are hopeful that he'll recover fully, but he has a long road ahead.

Prayers are appreciated. I, for one, have prayed more in the past 6 weeks than I ever have in my life. I've prayed for my parents' lives, for healing, for the knowledge and skill of the physicians, for progress, for the effectiveness of antibiotics and surgery and physical therapy. I've prayed for peace and comfort for my father, that he would feel God's presence and not be scared or depressed as he comes in and out of sedation. I've prayed for me. For strength and the ability to overcome sheer exhaustion in the days that I have managed motherhood and daughterhood and a full-freaking-time job. And I've prayed for my son. That Little B would never, ever have to experience something like this - either the illness itself or the need to care for his Mom and Dad under such yucky circumstances.

But this has brought my family so close together. My brother and sister and I sprang into action and were all in Atlanta within a matter of 24 hours. We have hugged and cried, made decisions together about my parents' care, crashed on my brother's couch, covertly sipped wine together in the hospital (it was practically a medical necessity at that point) and we have taken turns loving on each other's children. As adults (I am the youngest at 28), this situation brought us closer than we have been in years. Silver lining, maybe?

I don't write this to frighten you or make you paranoid. But Necrotizing Fasciitis hit my exceptionally healthy family out of left field, and I wish we had known to be more cautious. I don't know that anything could have prevented this - to a certain extent it's just one of those things. However, my hope is that we can increase awareness and preventative measures and spare another family the awful ordeal that mine is going through.

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