Naomi Update – The Knee Has To Go

Moderately graphic images below, view at your discression.

Today has been a very rough day. I was planning to spend the day shopping and preparing for Manifest after visiting Naomi in hospital first. When I arrived however, Naomi had been given some bad news, so I stayed the day with her.

Unfortunately, upon further investigation and after allowing the bacteria found in the samples taken from Naomi’s knee and blood to grow, it was determined that the abscess on the knee was actually infected. The infection was also found in the joint itself, and in Naomi’s blood. The infection bacteria is Staphylococcus epidermidis

After lots of visits from doctors and specialists from Infectious Diseases and Rheumetology, Naomi was offered a choice: a double knee joint replacement which would result in approximately 12 weeks of recovery, or to be on anti-biotics for life. The surgery seems to be the obvious better choice, but we have to wait to see the result of a big meeting planned tomorrow morning with the Osteopathy department and the surgeons. They will determine what they think is the best course of action for Naomi, given that they are the ones who will have to perform the surgery and look after Naomi. It’s possible that they will determine that surgery isn’t the better choice.

Naomi is also scheduled for an echo cardiogram to check to make sure the infection hasn’t spread to her heart – the organ most at risk due to the fact that all blood passes through it, now that the bacteria has been found in her blood.

Interestingly, the rheumetologist suggested, without actually saying, that the drug trial that Naomi has been on for the last three years may have had an important contributing factor in the infection. The trial, which gave Naomi initially wonderful results in the first year, then increasingly less so in the last two, is an immuno-suppressant. Arthritis is a disease where the body’s own immune system attacks the joints. This trial drug, and all others like it, suppress the immune system to give the body a break. Unfortunately it also lowers it effectiveness at fighting off infection. The doctor suggested that Naomi may not have had as much trouble fighting off the infection herself if she wasn’t in trial. Damned if you do, damned if you don’t.

I’ll let you know how the meeting goes.

Photos below – do not scroll down if you do not want to see moderately graphic images.

Here’s a couple of photos of the nurse changing Naomi’s dressing. After the surgery to drain the abscess, a large hole, about 2cm across, was left in Naomi’s knee. To help the healing process, the hole to the void once filled by the abscess has been packed with about 50cm of gauze. That’s what you can see sticking out of Naomi’s knee in the photos below.