March 24, 2017 started as any other day. I started my day with a swim, full day of work, and a store to pick up some necessities after work. It was around 3:00pm that I noticed a small sore spot on a knuckle of my right hand. The spot was peculiar, as I didn’t recall being bitten by any insects or injuring my hand in any way. The spot was small at first, about the size of a dime, but gradually grew in size, swelling and pain. By late evening, my hand was swollen and the swelling was progressing up my right arm. By 2:00am, the pain in my arm was the worst pain I had ever felt. I couldn’t touch or move my hand. I became physically ill with vomiting, diarrhea and little did I know, dropping blood pressure. I called my parents take me to the hospital (where I work), leaving my husband and children at home to sleep. After I hung up with my mom, I remember thinking “how in the world am I going to change my clothes?” I had no clue how sick I was.
The ride to the hospital seemed like an eternity. My parents helped me walk into the ED, where I immediately sat down behind the triage desk and said “I need some IV pain medicine and someone to do something with this hand”. The nurse immediately performed a quick assessment and vital signs that revealed an elevated heart rate and a systolic blood pressure in the 70’s. All I remember saying is “Oh my gosh, I’m septic.” I quickly received, IVs, antibiotics and consults. I was eventually moved to the intensive care unit (ICU) as I remained hypotensive and the swelling, discoloration and pain to my right hand and arm was becoming more severe.
This was an emotional time for my parents, for me, and for my husband and children left at home. Not only did I feel acutely ill, I had the nursing knowledge and background to know that what I was experiencing was severe and life threatening.
Infectious Disease was consulted and decided that surgery was urgent. My diagnosis was Necrotizing Fasciitis of my right arm. The Orthopedic surgeon sat down with me and discussed my options: “If you do not go to OR, you could die or lose your arm. If you go to OR now, I will save your hand, but you are going to have ugly, ugly scars”.
Over the course of four surgeries in six days the surgeon described the appearance of the inside of my arm as “dirty dishwater”. Waking up each time from surgery was difficult. I remember looking at my right arm. The swelling was severe; there were dressings, a wound vac and a discoloration that traveled up my arm. What there wasn’t, was a resemblance to the right arm and hand I was so familiar with just a day or two prior. The familiarity I did experience was through the care I received, and that care was incredible. What kept resonating with me time and time again was the thought that “This is how we give care to everyone”. I was receiving this amazing nursing care, and it wasn’t because I work here. It wasn’t because I am a nurse here. It was because we are committed to giving every patient we serve this same level of care.
It was prior to the last surgery that I experienced delirium. I would occasionally catch myself laughing as I watched my ceiling tiles turn into a swimming pool and my hanging room number outside of my room turn into a swinging toy for the monkeys that had made their way into the hospital. To know you are experiencing delirium is a bit surreal.
At the time, all of the little things that were done on my behalf were meaningful, but it has only been since that time, I’ve had time to reflect more that I’ve realized just how big the little things are to patients and their families. Things like nursing presence, fresh water and ice chips, warm blankets, reassurance to put your fears at ease, and vigilant follow-through on pain assessment and pain management make all the difference. To know that my call light would be answered quickly put my mind at ease. As much as I hated to admit that I was a high fall risk patient, I was happy to see the dedication of staff keep me safe from falling. The nurses-remembered us from day to day, shift to shift. The just talked to us and helped us feel normal, they were friendly and knowledgeable, which is what we needed.
After discharge, I vividly remember thinking, “this isn’t my hand” during each dressing change; I became distant from my arm. The swelling and discoloration was severe. There were dressings covering the wound vac and many sutures traveling up my arm on both sides. My support system of nursing colleagues, family and friends was phenomenal. Many times my nursing colleagues would assist with dressing changes and emotional support. My friends and family administered IV antibiotics to me- including my 4yr old daughter when no one else was able to.
Even in the face of this traumatic experience, I have fond memories. Recollections of compassion, generosity, empathy, unselfish giving, comfort, unsolicited help and friendship filter through my mind routinely. I often talk with my family of what they remember and what was said as some days are foggier than others.
On April 26th, 2017, I received a skin graft to the top of my right hand. The donor site came from my left thigh. From there, the healing process started and my emotional well-being soared with my support system. I never stopped living, I managed to coach my daughter’s t-ball team and be present at my son’s school activities. Despite the emotional and physical pain I suffered, this health experience opened my eyes to so much more.
This entire experience has been terrifying and inspirational all at the same time. My life-changing day may have started like any other day, but it certainly didn’t end that way. My life is forever changed, and I will forever be grateful for my healthcare colleagues saving my life.