My story so far

[dave....@gmail.com]

Hello all!

I have "officially" had a diagnosis of osteomyelitis since May 2007,
and chronic osteomyelitis since November 2007.

My story begins with a motor vehicle accident that happened on
December 27, 2006. I was riding my Vespa ET-4 home from work, and was
struck by another driver who failed to yield while making a left turn.
My scapula, clavicle, tibia, fibula and tibial plateau were all broken
on the right side, as well as ribs 4 through 8. In addition, I had two
open wounds on my right leg - one just northeast of my patella, and
the other at approximately mid-calf, right over the growth plate in my
tibia.

I had several rounds of surgical treatment for the leg fracture,
including external fixation, internal fixation, debridement and
irrigation (3 times), a wound V.A.C.(vacuum-assisted closure),
implantation of antibiotic beads, and multiple courses of oral and
intravenous antibiotic therapy (IV cubicin, Invanz; Oral minocycline,
doxycycline, Zyvox, Rifampin, Levaquin), none of which has proven
effective against my bone infection. I also had surgery to remove my
retained hardware as it was clear the hardware had become infected and
was harboring pathogens, and had my leg surgically cultured multiple
times - all to no avail. The only culture that ever returned a
pathogen was the one done in February 2007, at which time they found
fusobacterium - a pathogen often implicated in sinusitis, which makes
sense, given that during my initial hospitalization in January 2007, I
remember one of the nurses sneezing directly into my open wounds as
she was changing my dressings.

Here we are, 12+ months after the initial injury, and my leg remains
infected with God-knows-what, and the proximal tibia is still split
into three distinctly separate pieces with no sign of healing. I am
now pursuing a course of surgical treatment for my osteomyelitis, with
Dr. George Cierny in San Diego, California. Later this month, Dr.
Cierny will be removing the infected parts of my tibia and the distal
femur, implanting stablizing plates and rods impregnated with multiple
types of antibiotics, and essentially straightening my leg for a
period of 10 to 12 weeks so the remnants of infection can be cleared
from my body. After this first procedure, I will see Dr. Joseph
Namnoum in Atlanta, GA (my current hometown) to have a free flap
procedure. Dr. Namnoum will harvest my left latissmus dorsi muscle and
graft it onto my damaged right mid-calf, pulling a branch of the
femoral artery to provide the free flap with circulation and bringing
essential new and healthy tissue into an area that has been seriously
degraded and damaged from my disease process. Dr. Namnoum will also
implant more antibiotics in this area, to further safeguard against
any remnants of infection, and our hope is that these two procedures
will, over the course of three to four months, provide sufficient
healing to allow me to receive a total knee replacement on my right
side after the infection is gone and the leg has healed.

Whew! That was a mouthful. I just wanted to lay out my own chronology
for revieew and commentary. From speaking with other osteomyelitis
patients, most of us have similar stories to tell, and it seems that
many patients end up with osteomyelitis, as I did, even while being
aggressively treated by healthcare professionals. I believe this may
be due to a delay in receiving an accurate diagnosis of osteomyelitis
as well as a lack of targeted and effective treatment strategies on
the part of the patient's healthcare team. If orthopedic trauma
patients coudl receive a more timely assessment for the potential for
osteomyelitis, perhaps earlier intervention would reduce or even
eliminate the frequency of lost limbs due to untreated/inefficiently
treated infections.

Part of changing perspectives on osteomyelitis requires increasing
awareness of the disease amongst victims of orthopedic trauma as well
as among their healthcare providers. Educated patients will stimulate
overburdened practitioners to consider osteomyelitis earlier in the
game, which will increase the likelihood of accurate assessment and
earlier treatment, increasing positive patient outcomes.