(WARNING: GRAPHIC!) Cellulitis or Something Similar

The Lead-Up:

So, it's around 6p at night, visiting a friend in Takeo province. We'd been going around town meeting all of his friends/teachers/family around town. We're sitting down and enjoying a good conversation and a good drink when all of a sudden...Ooh! Ow! Ah! What?! Ooh! I tried to stand up when a huge rush of pain went to my right shin. I try to walk it off, and...Hey! It's alright! We head out to his co-teacher's house to sit down and chat. After a half-hour, I go to stand back up and F&@%! What IS this?! The pain turned into a throbbing one and all at the same time I started to work up a fever, which I found out later was 101, and it lasted for 15 hours.

Well, it still hurts, but it's not as bad as before. I'm going to visit some friends out in the town of Angtasom (You're thinking: Man! Is he dumb?!). After a nice tuk tuk ride and a good walk (if you're one of two people, you know what that means), I arrive at my friend's house. We decide to cook up some french fries and onion rings. The pain comes back little by little, but it's nothing I can'....hmmm, maybe I should sit down. I lay down for awhile while my friends grab me some water. I try to sit ba...nope! Nope! That's not happening either. I call the PCMO (Peace Corps Medical Officer), and she suggests some Ibuprofen and to ice the leg and keep it up above my heart. Also, I forgot to mention, my leg is hot to the touch. I can't actually move around, so they call me a tuk tuk. When the tuk tuk gets there, both the driver and one of my friends have to help me in. By the morning, I can't even get my phone, so I call back the PCMO, and she has me come into Phnom Penh.

The Process:

I get into Phnom Penh and the first place the driver stops at is a lab to get a blood sample (quickest blood draw, ever). Next stop is the Peace Corps office. I get a pair of crutches and lie down for a good 2 hours before the results come back. My white blood cell count: 18,000. Normal is 5-8,000. Sounds like a pretty serious infection to me. As the PCMO gets me into the car, I pass a joke about the leg, and she says, "Don't joke about that. Not right right now. This could be osteomyelitis (infection in the bone). I get taken to the hospital to get a blood culture, and then off to another hospital to get 2 x-rays taken; it's not osteomyelitis...phew! We head to the dermatologist just to make sure it's not anything other than a small soft-tissue infection. He takes a good look for a good 10 seconds. Yes, I think this is cellulitis. "We need to perform minor surgery." Huh? What? Excuse me? Can you please repeat that? "When would we need to do this?" "Now," he says. "If you wait two or three more days, I think necrosis." Oh! Great. (And here, I was just thinking I'd get some antibiotics to throw down the hatch) So they coat a nice bit of wax-based anesthetic (I mention this because now, I'm silky smooth there) gel on my leg. In about 20 min, they stick me with some Novocaine and cut into my leg a decent sized hole. After this, the dermatologist squeezes my leg tightly to relieve all of the infected fluid in my shin. Rather than closing up the wound, they shove a bunch of sterile, iodized gauze in my leg but just enough to leave the bottom of the incision open so that the wound can heal from the bottom up. They rub it vigorously with some iodine, rub a little triple-antibiotic on it then slap a loose piece of gauze over it. Then, they inject me with some antibiotics in both of my inner thighs. You'd think I was done, but you would be wrong. The continue to inject me IM into both cheeks, one is 1 cc, the other is 10. I get back up and they send me back to the office to lie down on the couch before taking me to my hotel room. For the next four days, the procedure is: stick around in the hotel room without moving and my right leg above my heart until the PC drivers come to get me. Usually, between 2-4, I get taken to the office and they inject me with the same antibiotics: one, 1 cc, the other, 10. One of the days, they spared my poor gluteus maximus and just had me on an IV for about 30 min. Each day, they also had to remove the gauze in my leg (which to me is best described as a magician pulling ribbons from his mouth) and replace it with just a little bit less gauze. On the fifth day, they started me on 250mg of tetramazoxafhirhhlrol and 250mg of Ceprofloxin two time, daily for five days total. After the 3rd day, the put me on some lactobacillus probiotics to heal up the damage from the antibiotics.

The crazy thing is: no one has any idea what actually caused it. Joanne (the PCMO) thinks it may have been caused by the simple scratch of a thorn or other sharp plant. I don't remember ever being abrased by anything.

Let me tell you: being put up in Phnom Penh sounds glorious and all, but you go a little crazy not being able to move around in that little room. I even got hooked on 5 t.v. shows that I couldn't follow up on! How cruel is that?!

Walking was a little difficult for the next week, but eventually, I was off the crutches and moving around alright.

Asante sana to several people:

Aaron for telling me: "Yeah. I don't think that's normal."

Libby and Danielle for helping me get back to Takeo Town.

Ashley for keeping me company the first night in Phnom Penh and bringing dinner up to me.

Angela, Hannah and Jane for keeping me company and bringing me food the next four.

The guy at the front desk at Phnom Penh City for getting me pork and rice each morning.

Mostly, thanks to Joanne for helping me not lose my right leg. I won't lie; it was pretty bad.

For your viewing pleasure:

The Gauze:

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The Hole:

Talk to you soon,

Garrett