That Halloween passed in a blur. We dressed Owen in her pumpkin costume and answered the door, trying to summon some cheer. Paul watched Charlie Brown with disinterest. Mom kept busy in the background, making sure we ate dinner, getting the dishes and laundry done and the thousand little things I no longer had the time or energy for. We made happy play for our baby girl.
For the next few days, Paul stayed on the couch. The Demerol dulled the pain, but it was always there, and he could never get comfortable. We called his orthopedist. His regular surgeon could not see him, but we were able to get in to see a colleague in the practice--a guy who specializes in hands. Fine, we said, just so someone can see him.
This surgeon was smiling, tanned, handsome, and arrogant, and it seemed as if he had just stepped out of a TV show about young hotshot orthopedic surgeons. He looked at Paul, looked at his x-rays. Nothing seemed unusual. Knowing, from Paul's chart, that a total hip replacement was inevitable eventually, his recommendation was to go ahead and get it done. Perhaps there was a hairline fracture in the socket--something that would not have appeared on the x-ray. We consulted his regular surgeon by phone, and the total replacement was scheduled...two weeks away. Pain meds would have to get him through until then.
So we waited. Paul suffered, trying his best not to overdo the pain meds (which barely gave any relief in the first place). Mom stayed, working her background magic. I went back to my work schedule, coming home whenever I could to relieve Mom.
I'm not sure when the chills started. Paul didn't tell me about them until they became unbearable, a few days before the surgery. His body shook violently, his teeth literally chattering. He could not get warm. I wasn't sure what to do, and, admittedly, half wondered he was playing the whole thing up, so I did nothing about it.
His parents came for the surgery. I called our dear friend, Chris, Paul's best friend, now a nephrologist in Florida, to let him know what was going on and ask for his prayers and good wishes. He was on duty, so could not talk at length. He said he would call Paul the night before the surgery.
That evening, the chills were quite dramatic. It was clear something was terribly wrong. I finally wised up and took his temperature. It was 102.5. Just then, Chris called back. We told him what was going on. The news alarmed him. A fever that high is not normal in adults, and given the pain of the prior two weeks, it appeared to Chris to indicate infection. He advised we not only cancel surgery, but that we go to the emergency room--immediately. We called the on-call physician at the orthopedic practice, who poo-pooed the opinion of a mere nephrologist, and simply said to go to the emergency room "if you think it will make you feel better." He did advise we cancel the surgery.
Ultimately, we decided the best thing to do was to take Chris' advice. An infection didn't seem to be something we should take lightly. So off we went, 8pm, to the emergency room. We stayed for eight hours. Emergency room physicians examined him, the on-call orthopedic physician examined him, more x-rays, blood draws, etc. The all seemed stumped. Infection, they said, was an unlikely culprit. After all, while he didn't look great, he didn't look as if he was septic.
They were very curious about one thing, however. In the days before, Paul had developed an odd new symptom--the joint of his forefinger had become swollen, tender, and red, as if fluid had pooled there. Strange that, but, oh well, he probably just hit it and didn't notice with all of his other symptoms. They drew fluid from it anyway, just to see.
They sent us home, finally, at 4am, advising he put off the surgery until their lab returned cultures from the blood samples--a couple of days. Paul was scheduled to appear to pre-op at 7am (the ortho surgery was scheduled at a different hospital--an orthopedic specialty hospital in Durham, the next town). So we showed up anyway, Paul miserable and sweating, yet racked with chills. We asked to speak to the surgeon, who took one look at him and sent him home. "Let's see what the cultures say."
That afternoon the emergency room called back. Paul should return immediately to be admitted. His blood cultures had rapidly grown bacteria. It was infection. He needed intravenous antibiotics right away to begin fighting it.
This time in the emergency room, there was no hesitation. His temperature upon arrival was 105. Nurses swarmed him, packing his body in ice packs, giving him IV fluids, drawing more blood. Six hours later, he was in a room, dozing in exhaustion. I sat in the dark beside him, shaken to my core.
Over the next few days, we learned more. Paul had a serious infection--staphylococcus aureus, commonly referred to as staph. Worse, the infection was in his bloodstream and, therefore, throughout his body (including his joints--hip and finger). Had he gone ahead with surgery, had we ignored the symptoms hoping they would pass, had Chris not called when he did and propel us to action, this infection would have killed him. My six-month-old daughter would have lost her father. I would have lost my best friend, my partner, the love of my life, and all of my dreams.
Despite the fact that we were still falling, spiraling into our dark hole, I know that angels watched over us, some of them taking physical form.
(to be continued)