Wayne Rohrbach

My name is Wayne from Ventura CA. It is amazing how much a small one inch scratch on the bottom of your ankle can change your life. I don't know where it came from or how I got it just one day it was there. Being diabetic, I accept that small cuts and wounds especially peripheral ones are going to take a long time to heal. I applied antibiotic ointment to it, washed and cleaned it daily but mostly just monitored it to make sure it never got worse. It never did get worse or so I thought. Over about a six week period there was no real improvement however there was also no swelling, tenderness, pain and the redness was never any bigger than the size of a dime. This is the beginning. The next section was told to me because frankly I don't remember any of it. Sepsis can do wonders with your memory. It started to get bad at work on Friday April 28th. I apparently called my supervisor to send in a replacement because I told them I had come down with the flu and wasn't going to make it through my entire shift. I don' t remember making that call. I don't remember driving home (scary). In fact, I don't recall anything until they woke me up in CCU on the morning of Thursday May 4th to ask me the dreaded question which I'll talk about later. I managed to make it home and spent most of Saturday and half of Sunday sleeping trying to get better from this bad case of "flu" which I lucked into. By Sunday afternoon, I started to become incoherent to the point where I no longer made sense to my family. They couldn't totally wake me. I was doing things I wouldn't normally do or say. The only thing I was adamant about was not going to the emergency room. My wife spoke to my doctor on the phone. He said watch me overnight for any signs of fever, chills, cough, vomiting etc. and if anything presented take me to the emergency room right away. Otherwise just bring me to see him first thing in the morning. I managed to make through the night unscathed. Except, at 4:30 a.m., I got up to go to the bathroom, this is where my wife first noticed some redness around the scratch on my left ankle. Most of my calf was red but still no pain or swelling. I arrived at my doctor's office the next morning right when they opened. They took my temperature and blood pressure as well as my blood glucose levels and within 30 minutes they had to call in to the emergency room to let them know I was on my way and there was no time to lose. Fortunately the hospital is less than a mile away from the doctor. Soon after I was at the E.R. kicking and screaming all the way. (I really hate hospitals). Funny, even though I didn't know where I was or where I had been I still managed to let my feelings about hospitals be known to all. (side note: sorry to all those I cussed out during my first few hours at the hospital). I underwent a battery of tests, as you can imagine, when the first reports came to my family that I had a temperature of 104, a source of infection origin undetermined, and my body has gone into septic shock with some of my internal organs already shutting down. "Wait he's only 48, what do you mean his prognosis is poor?". Fortunately, or unfortunately, depending on how you look at it, the surgeon in charge had just recently lost a middle age man within the last two weeks to necrotizing fasciitis streptococcal group a "flesh eating disease" (please forgive any spelling errors with this disease). He knew what to look for and did surgery that evening on my leg to open it up, look inside, and make sure that was my problem. He already knew that it was. I had already been placed on every antibiotic known to man and so far the results had been encouraging. My temperature was down, current lab results were improved and more importantly, my wife was told by the surgeon that my case of NF was relatively mild and that tomorrow's surgery (to clean out the actual dead tissue) along with the antibiotics improved my prognosis. The bacteria was no longer spreading as far as they could tell. Before the next day's surgery, my wife had noticed some redness spreading upward along the inside of of my thigh and asked the surgeon to check it out while I was undergoing surgery. All of this took place while I was in la la land. The morning after surgery was Thursday May 4th. They finally woke me up that morning to ask me a question that will be the source of my nightmares for as long as I live. "Wayne, we will need to amputate your leg or your prognosis is very poor". "What do you want to do?". These were the first and only words I heard that morning. When you are awakened and have a ventilator in your mouth obviously you can't ask any questions. You must rely on bedside manner of your M.D. or in this case my surgeon to explain to me what's happening. At this point, I knew nothing. I didn't know where I was, what was wrong with me or why did I needed to have my leg amputated in order to survive. I had to make this decision right away. Each passing hour lessened the chances that they could "guarantee" success. To me there was no decision. "Prognosis is poor" means you are not going to survive. What kind of decision is that? Only 48 years old, 3 kids, happily married for 21 years with nearly a completely normal life ahead of me with prosthetics and the like. Somehow, I managed to nod my head in agreement. Let's get the ball rolling. While removing the dead tissue during the previous operation, the surgery staff decided not to take the chance that they could find and remove all the bacteria hiding everywhere in the lower half of my left leg. It was safer for me to remove my left leg below the knee. They also opened up my leg above the knee to just below my crotch along my inner thigh to inspect the line of redness noticed by my wife the night before. Fortunately, this part turned out to be nothing so they could proceed with cutting below the knee. From what I have learned, being able to save the knee and creating the stump below it makes prosthetic fitting and adjustment easier in the future. I would accept any good news at this point. My wife was finally informed about what they were planning to do and insisted on a second opinion. She was able to reach the surgeon who did minor foot surgery on me ten years earlier. He was there within two hours to inspect the leg. He agreed that it would be better and safer for me to proceed with the amputation as planned. As it turned out, this second opinion did a lot to ease my future state of mind. I found out later that my current surgeon, had within the last two weeks lost a middle age man to the same disease and stated he would not lose another patient because he waited to long to cut. Without the second opinion, I would have forever wondered if he had become "gun-shy" and was there a reasonable chance that my leg could have been saved. I woke up on the afternoon of May 5th, with the lumps in the sheets extending longer down one side of the bed than the other. About 14 inches longer. Now was the time to gather as much information about what my future had in store for me. How long would I be in this hospital? How long to heal? How long to be fitted and adjust to a prosthetic leg? How long 'til i can go back to work? When can I regain the life I once had? The surgery had gone very well. I was kept on IV antibiotics for three more weeks. I had two additional surgeries to prepare the stump for future prosthetic fittings including rearranging some of the muscles in and around the knee to replace some of the muscle damaged by the bacteria. Except for a one week battle with severe diarrhea, (thanks to all the antibiotics) recovery went pretty well. There was some concern with my white blood cell count remaining higher than normal. Was there an additional source of infection? Or worse yet, had they not removed all the bacteria or dead tissue? I read too much. So I suggested that they check out the subclavian line that they had sticking out of my upper chest for the last 17 days. They agreed and removed this line which allowed my white blood count to normalize within two days. Being an M.D. can't be that hard. Two days post -op in C.C.U. followed by a stay on the medical floor followed by a very helpful ten day stretch on the rehab floor and I finally went home on May 26. The next phase of recovery involves mostly waiting for the leg to heal. Once it heals it's on to prosthetic casting, temporary leg, adjustments, another temporary leg, more adjustments finally the real mccoy and the building up of stamina and more adjustments. I was cleared by the surgeon to start the prosthetic process with my first appointment scheduled for tomorrow. I will update you on all that's happening when it all starts to happen. I chose not to dwell on the negatives. Why me? and all that. It happened. Couldn't really be avoided. Unlucky? Yes. Lucky to be alive? Also yes. Life goes on for me and all the survivors of this horror. May god bless my family and friends for all they have done and continue to do for me. I have learned a lot through all of this. There are many caring and loving people in all aspects of medical care. There was always someone to talk to whenever I needed it. I learned that dealing with insurance companies generally sucks. Most important, if you have people, especially like my wife, who love you, there isn't much you can't overcome. God bless all of you and may there be more stories of survival and fewer dedications from now on.