William Lavelle

Survivor

Writer is a 58-year-old male, now retired /disabled. I am a survivor of two separate sepsis events. It’s no surprise that after 10 years of football into division II., USMC, and giant slalom racing that my knees wore out early. By age 25, I was told the knees are shot and to delay surgeries until I could not take the pain any longer.

By 50 years of age, I gave in and had my first left knee replacement. Seventeen months later I had my second knee replacement in spring of 2012. All was going very well albeit my ortho surgeon wanting me to lose the weight that was gained over years of declining activity.

In 2015, my right knee began to feel different and painful. In time, I went to my ortho surgeon and upon x-ray review, he informed me that the knee had come loose. The doctor told me that the prothesis losing its adhesive bond happens rarely. We scheduled the surgery date and I began the pre-operative rounds. (Sepsis and Joint Replacements, Sepsis and Surgery)

After going in and out of many appointments for scans, check-ups etc., one morning I felt as though I may have caught the flu. I stayed home and worked from the home office. By late afternoon the left leg, unremarkable in the AM, had turned reddish pink. My wonderful wife telephoned the GP and we were told to go to the hospital.

We arrived at the ER and was received quickly. I recall not understanding what the big deal was. I’ve endured far worse in my life. When being moved to the ICU, I recall explaining to the nurse that the ICU is for sick people. She told me I was plenty sick and this was the best place for me. I continued to not fully understand the gravity of my situation.

It wasn’t long before I topped 105 F temperature with a blood pressure of 55/20. I recall thinking the instruments are not working correctly and they really should remove the dog that is running around in ICU. It was me not working correctly. Most of my stay at the first hospital was in ICU with the exception of a trip to OR for left knee debridement (cleaning). I had a vivid life struggle dream during the procedure that would act as a preface to many dreams and hallucinations to come. On a humorous note, the post-op nurse asked if I wanted a Tylenol suppository. I recall telling her I wanted nothing that ends with the word suppository. I took the medication anyways since it seemed prudent at the time.

I came out of septic shock and surgical procedure enough to be transferred to my ortho surgeon’s Abington PA hospital. Before leaving my local hospital, I listened to a few doctors tell me their thoughts on how I acquired the cellulitis and sepsis. (Sepsis and Cellulitis) One doctor actually suggested that my dental hygiene was deficient while standing across the room and never coming within 10 feet of my bed. Finally, an infectious disease doctor told me not to think too much about how I acquired the infection because it could drive you crazy. He explained there is so much not understood.

After arriving at the second hospital, the diseased left knee was removed and an antibiotic spacer was put in place. I did my best in PT with a spacer in one leg and a loose prothesis in the other. In time, I had the left knee replaced, rehabilitated, and then had the right knee replaced before the end of 2015. My surgeon told me I had a year from hell and let’s hope 2016 is better. At the time, I couldn’t imagine it getting any worse.

Medically, 2016 was a pretty good year. Although I had record breaking sales in 2015, my then employer wanted to compensate me ½ commission to compensate for loss of office time. I pushed back and was paid according to plan. However, the employer moved my office into a building a ½ hour further from my home and into a windowless closet where people came in and out throughout the day for filing. I had the oldest office furniture and the least ergonomically considered work space in the company. Eventually I was reclassified as a contract employee. I was separated from that company along with my 10 percent ownership of the LLC at $0.00 in compensation. It appears that some employers will discriminate and move to pressure you when health begins to fail. Clearly employers lack sepsis awareness.

After being let go in May of 2017, I began employment with another company as Plant Manager. Unfortunately, I was there just past 90 days when involved in a work-related accident that caused my right knee again to become loose and painful. Before I could schedule the corrective surgery (s), I again contracted cellulitis even though I was showering daily with Dial bar soap and brush. Dial bar soap has an antibacterial and moisturizing component typically not found in other soap.

The infection and sepsis were worse than in 2015. While going through the various procedures and medical events, I am unable to recall the first 30 days of hospitalization. This time was different. I felt unsure and isolated. It was nice having my family support as always, but some how I was unable to appreciate fully. I eventually was able to see that everyone cared a great deal about me and this aided my return to what, I was unsure.

After 4 months of hospitalization and rehabilitation care, I was able to return home. I learned that my ortho doctor claimed the knee was removed because of the cellulitis and not because of the damage from the work accident. Worker’s compensation is not agreeing with my position and not providing any resources to my cause. I also did not collect unemployment and Social Security Disability seems the option to pursue as I write.

I’ve done a lot of research on the subject in the first 30 days home. I do not believe that neither the 2015 or the 2017 cellulitis and sepsis attacks are based purely on the Joe Bazooka explanation that bacteria penetrates the skin and sometimes you get cellulitis and sometimes you avoid the wrath. Personally, I believe researchers who are further exploring Periprosthetic Joint Infection (PJI) with remote instance of cellulitis presentation have the begins of a much-needed awareness for the prosthetic, cellulitis, and sepsis survivor communities. With more implants occurring daily, the data must attempt to capture the reality of the situation and be critical of statistical fudging.

I am between stage 1 and 2 of my right knee replacement. This has me at home, in a wheel chair, attempting to improve my immune system. I am petrified of both hospital and community acquired infections. I may go on with stage 2 in fall of 2018 or possibly not pursue completion. I am afraid that a third and possible final round of sepsis shock will be the end of me. I would feel better if the complexities of the human anatomy enterprise were better understood. I’ll do what I can to fight what is right, hopefully we learn the better methods and understandings as soon as possible.

Best regards and wishes to all,

Bill Lavelle
Survivor ’15 & ’17

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