Arthroscopic Surgery and the PICC

The symptom was innocuous: a sudden fever after I ate a bad piece of “bao’ – “siopao” as we call it back in Manila. My body reacted by trying to throw it out of my system when I took a brief shower. I was sure that I didn’t get rid of all of it. The fever swung to highs and lows as I tried to battle it by taking only Tylenol every four hours. On the 4th day, I felt way much better and tried to work myself back to my normal routine by doing some yard work and light household chores. It was not back-breaking work, but it was all the bacteria needed to strike back at me at the end of the day. The following morning, not only I had the fever back but I also had severe pain on the top portion of my right knee. There was no swelling but, merely touching the area elicited very sharp pain and walking was extremely painful.
After the sixth day, I gave up all hopes of self-medication as the fever shot up to record highs and walking was now excruciatingly painful. We called the hospital -Kaiser Permanente- and immediately got an appointment for the following day. At the hospital, blood, urine and synovial fluid samples were taken as well as x-rays for my chest and the right knee. The fluid drained from my right knee didn’t look too good and I was wheeled directly to the ER. There, further blood and synovial fluid samples were taken and I was put on IV. An orthopedic surgeon was brought in and talked to me briefly about my kidney operation of 1981 – when my right kidney was removed due to hydronephrosis and pyelonephritis. He suspected that I had urinary tract infection and that it had caused the fever and the severe pain in my right knee. He tapped my left -and remaining – kidney to elicit pain as well as the area above my bladder. I told him that there were no pain in either place.
The surgeon returned to explain to me that he had to perform an emergency arthroscopic surgery on my right knee to get rid of all the “bugs” and infection in there. Worse, he will have to open up the knee (arthrotomy) in case the infection was much severe than he thought, to eliminate the possibility of the infection, doing more damage to my still-intact knee. The knee x-rays revealed no ligaments nor meniscus damage but having the infection remain in the knee for some time, can do severe damage to those healthy tissues in a small amount of time. So, that same day, very late at night, I was wheeled in to the OR for either a quick arthroscopic surgery or a much longer, open-knee surgery. Inside the OR, I was probably awake for only five minutes and quietly prayed for the best. It was way past midnight when I woke up to find myself on the recovery room, with my right foot heavily wrapped in elastic bandage and a much thicker foam wrap secured by velcro straps to immobilize the area from the top knee down to my ankle. There was also a MediVac (drain) coming out of my right knee via a rubber tube.
After the second day on the hospital, the drain was removed. The following day, all the straps and bandages were removed. I was glad to find only three slits on my knee (two at the bottom and one on top): ONLY arthroscopic surgery was done and my knee was not opened-up. Still, without the pain killing medication (Vicodin), moving the knee -specially sideways – elicited severe pain that rang up my entire CNS (central nervous system). All throughout this ordeal, a wide array to antibiotics were administered on an 8 hour cycle via IV, while the doctors awaited the result of the blood culture and sensitivity (C/S) for the best antibiotic to use for that particular bacteria that caused the infection. My right knee was still swollen like an overripe papaya.
On the 4th day, the most effective antibiotic seemed to have been found and the doctors informed me that a PICC line will have to inserted so that the antibiotic can be administered after I get discharged from the hospital.
On day five, the PICC (Peripherally Inserted Central Catheter) line was inserted after a 45-minute OPD procedure. It was a very, very slender piece of plastic tube inserted through a vein in my right arm (the nurse informed me that this route was shorter) that was initially guided by a thin piece of wire. The tube snaked all the way up to a large vein (subclavian vein) situated very near the heart. The main idea was to deliver the medication/antibiotic rapidly to my bloodstream while diluting it at the same time in that area where plenty of blood rushes by, for a longer period of time than drip IV (usually good only for 4 days). As a standard procedure, an X-ray was taken to make sure the PICC line was in place- otherwise, the entire procedure will have to be redone. I was also informed that the PICC line will remain in my body for two weeks. That done, I was out of the hospital after a few more hours of briefing — all related to the arthroscopic surgery on my knee and the PICC line they had embedded in my body as well as how to administer the drugs at home.
For now, I’m simply looking for better days ahead –to return to my routine. But this time around, I will simply be more thankful for each and every day that will pass.
Simply being healthy is, indeed, a feeling of already being wealthy.
—links:
www.kaiserpermanente.org
www.arthroscopy.com
www.thefurrymonkey.co.uk/picc.htm