Diagnosis: infection


First came the diabetes, and all the dietary restrictions that accompanied it. Doctors and nurses often warned us about possible complications of diabetes, but it was ten years later, maybe longer, before there were any complications. And even then, we were never quite certain that it had anything to do with diabetes. At the time, what happened next just seemed strange and random.

Steph worked downtown, and she usually took the bus to work. There's a bus stop two blocks from our apartment, and the bus dropped her 2-3 blocks from her job, so it was an easy commute. One icy winter morning, walking to the bus stop, Steph slipped on the ice and smacked her shin into the sidewalk. It hurt, and it drew blood, but it was a minor annoyance. She went to work, put a bandage on it, and mentioned it in passing when she came home that night. Seemed like not-quite-nothing, but certainly nothing much.

A few weeks later, though, the bruise hadn't heeled, and that area of her leg pained her with every step. She went to her doctor, who said it might be infected and prescribed some antibiotics. The antibiotics gave Steph diarrhea but seemed to have no other effect, so a week later the doctor prescribed a different antibiotic. And still, the bruise wouldn't heel, and the pain was increasing.

When the second antibiotic didn't work, they x-rayed her leg and pronounced the infection "severe." The doctor recommended a surgeon, and at this point we knew we were dealing with something weird. Have you ever heard of a slip on the ice leading to surgery?

We met with the surgeon, whose explanation was "These things happen," which didn't really explain anything but by then we'd come to conclude that "why" was a question that wouldn't be answered. And if surgery could solve the problem, of course we'd be happy with surgery. The plan was that the surgeon would remove the infection, along with some of the skin and muscle around it. Steph was admitted to St Mary's Hospital in Madison, where she stayed for two, maybe three nights.

We found the experience odd. Their care was more than competent, the nurses were compassionate, and everyone seemed to care, but three different staffers volunteered to pray with Stephanie. Is that weird? We thought so. The name St Mary's Hospital is a clue; it's run by some non-profit that's connected to the Catholic Church. But we weren't religious, and nobody asked if we were religious; people just kept coming into the room, asking if Steph wanted someone to pray with.

The food, I remember, was quite bad. That's what you expect with hospital food, but Stephanie was always picky about what she'd eat, and meal after meal at the hospital she deemed inedible. I was "visiting" her room, but actually sleeping in a chair overnight, every night, at Stephanie's request. And after a few meals that she couldn't stomach, I began bringing her meals — McDonald's Filet-O-Fish one night, a sandwich from Milio's the next day, etc.

Before the surgery, Steph was scared but brave, and I was scared but not so brave. I tried to talk her out of talking about it, but at her insistence we discussed wildly-improbably worst-case scenarios before they wheeled her to the operating room. "If anything goes wrong, I want to be cremated, and please take good care of the cat." Dark humor, I'd call it, because we'd been assured and we certainly understood that this was minor surgery, with an infinitesimally small chance that anything could go seriously wrong.

The surgeon promised she'd come see me as soon as the surgery was finished, and she did. "Everything went well," the doctor said, "and your wife should be awake in half an hour or so." And indeed, half an hour later Steph was holding my hand, smiling, optimistic — my ordinary, extraordinary wife.

They sent us home with a machine attached to the hollow spot on Stephanie's leg, the hole where her flesh and infection had been. The machine loudly sucked up the pus and ick every few minutes, and twice daily we'd power down the suction, gently wash the wound, and reattach the pus-sucking machine. A nurse visited our home several times each week, checking on Stephanie's progress, and in six weeks or so the wound had healed, and the nurse took the pus-sucking machine away. Steph was soon able to walk, with minimal and fading pain. After a few months, there was no pain at all, and she was walking normally.

Other than the diabetes, Steph had no ongoing health concerns at that time, and nobody offered any warnings about kidney failure. A year later, though, a similar infection developed on Stephanie's back, addressed via the same protocol — antibiotics that didn't work, followed by surgery that left a hole in Steph's back, followed by a month and a half at home with another pus-sucking machine, as the hole slowly healed.

We asked every doctor, what's up with these strange infections? Why is this happening? And again the answers boiled down to, "These things happen." It was tremendously frustrating or worrisome. Obviously "these things happen" because these things were happening to Stephanie, but why?

The answer came later, after Steph was diagnosed with kidney disease, and the answer came from our own research, not from a doctor: Diabetes can lead to kidney disease, and kidney disease leaves anyone more susceptible to infections.

The horror of it all still makes me angry, that Steph — while always brave — was living her life in fear. In her late-30s, she was dealing with these crazy, unexplained infections. In her early-40s, she was dealing with a diagnosis of kidney failure, or as they cruelly call it, End-Stage Renal Failure. "End-stage," right there in the name of the disease.

She was hospitalized five or six times, maybe more, for assorted infections. It's a wonder, living through that, that Stephanie didn't become a grumpy, dour, sad woman, dwelling on the negatives. To me that seems an almost expected response.

Why didn't she become an insufferable, pessimistic grouch, when she had to face all those infections without explanation, plus all the kidney-crap day after day? That's another unanswerable question, but somehow, Steph was only pessimistic on rare occasions. She was upbeat and optimistic a good 95% of the time, even during her darkest days. It's another of the many things I admired about her and still do, and it's something I try to emulate, but usually don't.