Sunday! I didn't make it to choir practice or to Sunday School, but I made it to church. It was so nice to be back.

I came home and changed Dan's dressing. He said he wanted to try it without the pain pill. After I changed the dressing, he decided that he definately still needed the pain pill for when I push all of that guaze into his wound.

I won't be able to go to evening church as that is when his IV is due. Which, I'm so bushed, I'm not sure I could make it back in anyway.

My girls did great last night! They all looked good and we had fun.

It's all about the ice show today. We have solo practice from 3:45 to 4:45. All four of my students have their solos tonight. So, that means I will be staying for pretty much the entire ice show.
After I run into town for the solo practice, then I run back home to start Dan's IV, eat supper, stop the IV and flush it and then head back to town for the ice show.
Busy, busy.

I think his wound is looking better. It is not nearly as hard in the center as it was in the beginning. We are actually packing it with about 5-6 inches of guaze. (I was mistaken earlier when I wrote 1-2 inches) Dan corrected me!

You can't really see the picc line, but this is the giddup that he now has on his arm instead of the IV in his hand.
Dan is still pretty sick from the IV, but he is managing to eat about two meals a day with lots of snacking of very salty things. (Says it helps to settle his stomach).
I need to run into town for the ice show tonight. I'm not staying for the whole show. Just long enough to put the synchro team on the ice and to see them off the ice and then I'm gone. They are the first number in the show, so that makes it nice for me.
We took some more pictures of Dan's wound today. Today marks 3 weeks and 4 days. His arm isn't him so bad too day. He spent most of yesterday with the heating pad wrapped around his bicep, but today a lot of the stiffness is gone.

Dan is hanging in there. Today is not one of his better days. He just doesn't look to good. His arm, where they put the picc line is really sore and achy feeling. He has been wrapping his arm with a hot pad, which the nurse recommended to do. We did find out that with the line being right by the heart that it really circulates his antibiotic much faster and he gets nauseated right away after hooking up his IV. His dog bite leg is hurting him more today and we're not quite sure why. The incision area of the dog bite is looking better and the hard area is getting smaller. We are still packing it with about the same amount of gauze though, about 2 inches.

Well, I was able to get a shower and a nap in today before I went to the rink and it really helped. I got off the ice and made a bee-line for home to start Dan's IV. It was so awesome to not have to fix supper on top of it all. We had a wonderful chicken dinner with all the sides and even dessert! I'm am very tired right now, so I will be heading off to bed.

We were gone most of the morning getting Dan's PICC line put in. We were there a little after 1030. We went for Dan's x-rays around 1130 and they showed that the line was too far into his heart, so we headed back to the IV place and they pulled the line out 5cm and we were set. We stopped and got something to eat and picked up a couple of things at the grocery store. By that time it was afternoon and we were both very tired. We came home and took naps. Dan needed to put a heating pad on his arm to help prevent stiffness.

We hooked up his IV to the new site and it went well.

Well, it is off to bed. I was able to get a great nice long nap this afternoon when Dan napped. It really helped to change the time of his IV antibiotics. It had been at 3 to 3:30 and that is an awful time for me to have to hook him up. So, we are now doing it at 6pm and it worked great.

We have a great blessing coming to us tomorrow. Kyla, our pastor's wife is bringing us supper tomorrow night! It is such a huge relief to me. Tomorrow I am trying to get in 3 private lessons, the last Synchronized Skating class (it's actually dress rehearsal) and then I will get home at 6:15 to run Dan's IV. It is such a huge relief for me not to have to fix supper on top of all of that.

Then Friday and Saturday is the ice show.

Dan had his Dr. appointment today with the infectious disease doctor. Today is also the 8th day of being on IV antibiotics. I was hoping that Dan would be free of the IV's and just have the wound to deal with. But, that isn't going to happen. After today's dose of antibiotics I am able to remove Dan's IV. Because, tomorrow morning they will inserting a PICC line into his arm. This is for long term IV's. I guess Dan is going to be on IV antibiotics for another couple of weeks!!! I have pasted some information about PICC lines below. He will have it inserted tomorrow morning and then will go have an X-ray to verify placement. I feel bad for Dan as he has to be sick from the antibiotics for another two weeks. Dan's leg is looking better but there is still some infected drainage.

Info on a PICC line:

For some years now doctors have been using central lines for some people who are going to have chemotherapy that would normally require a lot of injections and blood tests.

A central line is a thin flexible silicone tube, the tip of which is placed in one of the large veins deep in the chest (the superior vena cava). The line is put in under either a local or a general anaesthetic. The outside end of the line is on the chest, just above one or other nipple. It then tracks under the skin for a little way before going into a large vein just behind the collar bone. From there it goes into the superior vena cav

A PICC line is a more recent development using a line which is inserted into one of the large veins in the arm (usually near the bend of the elbow) from where it is threaded into the superior vena cavThe initials PICC stand for peripherally inserted central catheter.

PICC lines are normally inserted as an outpatient. Some local anaesthetic cream is applied to the skin which usually ensures the insertion is painless. The procedure takes about 30 to 40 minutes. Once the PICC line is in place it will be taped firmly to the skin with a special transparent dressing to stop it coming out of the vein. A chest x-ray will then be taken to check the position of the line before it is used.

The PICC line can be used for taking blood for blood tests, giving chemotherapy drugs or giving blood transfusions.

Once the line is in place nurses will show you how to take care of it, to prevent any blockages or infections. This will involve learning how to clean the external part of the line, change the dressings and flush the line through with sterile salt solution. This may sound complicated at first but the nurses will explain it all and make sure you are able to cope. They will also give you a contact 'phone number at the hospital in case you have any problems.

I'm struggling today. I feel pretty wrung out and tired. By the time we got home from the doc's office my chest was really hurting up to my neck and jaw line. So I did take an extra propranolol. I think I'm just over doing it.

The above picture shows a picture of Dan's IV bag, which looks like a little hand grenade. Cute huh?

I had a rough night last night. I feel much better this morning. I've been having more chest pain than usual, but I didn't want to worry Dan. He can't do anything about it.

I can't believe that it is 3 weeks ago that he had his dog bite. I'm still in shock at all that we are going through for a dog bite. We have taken some three week pictures. As you can see most of the actual bites are healed or scabbed over. Even the infected puncture wound is looking so much better and has finally scabbed over. Now we just need to get that wound to keep filling in.

We have to pack the wound to keep it from healing from the top and leaving a pocket underneath. By packing the wound it is making the wound to heal from the bottom up.

I made it to aquacise class today. Whew, what a work out. I usually rest when I get home from the class, but I couldn't today. Dan needed somethings washed, phone calls made insurance forms to fill out, etc. Oh, yes and lunch made. Things just really keep me moving.

Today is Sunday. Neither one of us were able to go to church. Dan is too sick from his IV's and he is afraid of his hand and/or his bandage being bumped. I'm just too exhausted. I'm not getting my rest periods. I run out of steam and start to feel bad and it's time for either Dan's IV or his dressing change or both. Then his IV takes about 30-45 minutes to run in and I need to stay up and alert to flush and disconnect it when it is done. Then usually it is time to fix something for supper.

I'm not managing my time very well I guess. I wish I was healthy then this would be such a breeze for me...

This picture shows the guaze hanging out of the incision before I pulled it out and restuffed him :) You can also see that there is still quite a bit of drainage. (hope I didn't gross anybody out). This makes Day 20 with 6 days post incision and drainage.

Well Ice skating competition was last night (Friday) and this morning (Saturday). With Lana's help I was able to get Dan hooked up to his IV and then went to the rink on Friday. She would come and unhook him and do his dressing change. Then of course for Saturday I left as soon as the competition was over. So, I am the nurse for the weekend. I am so exhausted from judging and trying to be alert and awake for Dan.

The good news is that the nausea pill is helping Dan and he is able to eat a little better. He still becomes nauseated but not as severly and for shorter spells. The bad news is he is pretty much out of it from the pill. He is still in a lot of pain when we do the dressing changes. We are packing anywhere from 1-2 inches of guaze strips into the incision that Dr. Dowell made. It is looking better but still feels very hard.

These are two of the pictures that Lana, the home health nurse took. It is about day 18 and 4 days after Dr. Dowell did the incision and drainage.

It took all day, but I was able to get the IV doctor to prescribe some anti-nausea pills for Dan. The only draw back is that they make him very very sleepy. He took one when I got home with the pills in within an hour he looked more relaxed not like he was gritting his teeth to keep from throwing up. When I asked him about it he said, Yeah, I haven't even thought about for a little while. So, that's a relief.

Lana, Dan's home health nurse, took some pictures of his leg today while she was here to do the dressing change. (Her and I scheduled it so that I could go teach a couple of lessons today.) I started Dan's antibiotic and she disconnected him when she got here and changed his dressing.

It's late and I'm really tired.

We went to the Infectious disease doc today. He said Dan's leg looks much better. He is very concerned at how sick Dan has become from the antibiotic. He said if we changed to another kind of IV antibiotic that it would be a three time a day, instead of daily. Dan didn't really want to do that, so he gave him a stomach med to try to help relieve some of the nausea. The drug is not for nausea though. He is still very sick tonight after starting that new med. I think that he is getting worse. I will probable give the doctor a call tomorrow and see if he can prescribe something specifically for the nausea.

I got some rest this afternoon but I'm still dragging. Tomorrow Lana comes out. I'm starting Dan's IV before I leave and she will take it out when she gets here and will change his dressing too. I'll miss that, so there probably won't be any pictures until I change his dressing on Friday.

I'm trying not to get too overwelmed with everything. I keep reminding myself to take one day at a time.

We are surviving! Kinda feel like we're treading water, every now and then you get a lungful of water and come up coughing and spitting, but you just keep going...

Today Dan is feeling really crummy. He looks horrible and I know he feels bad. He is very nauseated. (From the IV's) He is not eating much, except chicken broth. I managed to get some fried chicken down him (he'd been wanting that) and even then he only ate one drumstick.

I had to call Dr. Dowell's office today to verify what meds we are to stop and start and to ask him if he would call in some more pain pills for Dan. Yesterday while we were there he asked Dan if he wanted something for pain and Dan said, nah. Well, when the lidocaine injection wore off, he was a wishing he had something. So, they called in the same kind of pain med only a little stronger. They also confirmed that he is to stop the oral and topical antibiotics since he is on the IV antibiotics.

Then I called Dr. Landon's office to get his Naprosyn refilled for his left knee inflammation and pain. They did so without any problems.

See all of his meds have been previously ordered by the Instacare PA-C who had been following Dan. But, when he referred him out to the other doctors they assumed his care and the refills etc... OH! That PA at Instacare, whose name is "Dan". Called Dan today to see how things were going and what Dr. Dowell had done to him and what the plan was. He asked Dan to call him with an update on Friday as he has Wed and Thursday off. This guy was so very nice to us and didn't charge us for 1/2 of the visits or supplies. Instacare is a pay as you go clinic. They do not bill any insurance. We pay up front and then submit our own stuff to the insurance.

Lana came out today and finished the admission paperwork for Dan. She changed his dressing and hooked up his IV. I took some pictures of his knee. I can't believe it has been over two weeks since this whole thing started.

The insurance investigator for the dogs owner is coming to our house tomorrow right before we go into town for Dan's appt. with Dr. Dowell. We should know a lot more after tomorrow.

I cancelled all of my private lessons today but had to go and teach my last power skating class. It is only 1/2 an hour.

I'm just beat. I'm doing a lot more than I should, but I just don't have much of a choice. Dan can't do for himself. I realized how much he does for me when I went to the grocery store - it's been so long since I shopped that I couldn't find a darn thing in the store. So, much for running in grabbing 4 things and running back out!

We went to Instacare to see the dog bite doctor and he said for being two weeks out Dan's knee is not healing like it should. That large hard area inside the area of the dog bite, that we thought was a hematoma he believes is a large pocket of infection/abscess. So, he called the infectious disease doc and they wanted to see Dan in one hour.

Dan took me into my water class today and while I was exercising he went grocery shopping. We stopped at Instacare on our way home. So we had to hustle home throw the grocery's in the fridge and run back out again in order to make our 2:30 appt.

So, we barely made it in time and then we sat in the office and waited for about an hour or more. But, Dr. Dowell is worth the wait. He started first by opening up the infected puncture (tooth hole) with a cotton swab. It went in over an inch! Next he said that he needed to cut open and drain the the hard swollen area in the center of the dog bite. It was rough going for Dan. That particular area that he was cutting is also the sorest area of his bite. Dr. Dowell was only able to reach part of the infection. He said any deeper and Dan needs to go to a surgeon.

He ordered IV antibiotics to be done at home and now he has a big open wound that needs to be packed and changed daily.

So, we go back on Wednesday. If it's not improving he will need to get a CT scan of that knee to check for foreign bodies inside the wound. And, he will send him to a surgeon for further debridement of the wound.

We are just praying that the IV antibiotics will do the trick.

As for me, I'm totally beat. What a long, long day. Dan felt really bad when we got home. I think that incision and squeezing of the wound really got to him. He took a pain pill as soon as he got home. Then Lana, my former home health office mate, came out at about 6 to start his I.V. and get the antibiotic going. She will come tomorrow at 3:30 to finish the paperwork, bring out the wound care supplies, change his dressing and of course hook up the IV antibiotics. Then after that I will be able to take over. This goes through Thursday. I hope I can keep up with everything!

We are doing okay. We had a very nice Easter Service, I think the choir songs were beautiful, but then, I'm a little biased. The rest of the service was outstanding as well.

Dan's dog bite is healing except for that one hole. It is still draining. He still has a rather large hematoma in the center of the bite. I figure it will take some time for that resolve. Dan goes to the doctor tomorrow for the dog bite follow-up.

We are both pretty wore out tonight.

Dan has torn cartilage in his knee, the meniscus to be exact. He needs surgery, an arthroscopy. Eventually (several years down the road) he will need a knee replacement.

We can't schedule the surgery yet because his infection and scabs on his dog bite must be totally gone/cleared up. When that happens, then we can schedule the surgery. Poor Dan.

I survived today. I am so glad I made it. I feel much better mentally than I have felt in the last few days. I have been so overwelmed. I don't have anything until 6pm tomorrow!

Dan went to the ortho doc on Tuesday. He had an x-ray of his left knee, nothing is broke. He had an MRI later that day to see what is going on with the cartilage. We find out about those results when we go in tomorrow morning at 9:15.

Today Dan went to Instacare for his follow-up appointment for his dog bite. The one bite is infected. It is draining pus. He started him on a second course of antibiotics and needs to see him in five days. If it is not cleared up by then, he will send him to our infectious disease doctor here in town. That will probably mean IV antibiotics. We are also trying something on Dan's knee, that Dan's sister sent us. We have been using it since it arrived, so hopefully that will knock it out the rest of the way.

I'm not feeling real confident about Dan's left knee. It is locking up so that he can't bend it. I'm afraid that he is going to have to have surgery. We will know for sure tomorrow.

Kind of a rough week for me. So many things pulling me in so many different directions. Between extra choir practices, extra skating lessons, my chart audits are due, I'm still trying to to keep up with my water classes and trying to help Dan and to go with him to all of his doctor appointments. Oh, and my doctor's office keeps calling about me restarting my meds. I'm about ready to thump that nurse. I just don't have time to not have a blood pressure this week!!! Oh, and the natzi skating mom's are on the rampage again. I wish they would just get a clue and chill out. I'd like to thump them too, but I think a better punishment would be to lock them all in a room together!

Tomorrow I have Dan's doctor appt and 9:15am, I teach a private lesson at noon, go to Interim to do my chart audits, go back to the rink from 3:30-5 and do two private lessons and then stay for synchronized skating class from 5 - 5:45pm. Then I can go home and crash, after I fix supper for Dan.

At this point I've managed to keep Friday free for me to rest up, except for choir practice at 6 pm.

My careful scheduling for rest periods has been totally blown out of the water these last two weeks and it is starting to catch up with me. I'm not sure what to do about it other than to pray for May to come quickly. (skating ends)

Well Dan made it to church on Sunday, both services. He was very, very sore at the end of the day and walking like a penguin.

For some reason I was very anxious and crabby allllllll day yesterday. Today is much better. I did really well after my aquacise class. Usually it is all I can do to get home before I have to lay down. But, I was able to run three errands on my way home.

Tonight I am really tired, but that's okay.

I took more pictures of Dan's knee today, one week later pictures, but I will not be posting them until tomorrow or so.

Dan goes to the orthopedic surgeon tomorrow morning. So, we will know more of what to expect after that appointment.

I didn't have a very good day yesterday. I was trying to help Dan and I just couldn't do it. For the first time in a long time I had one of those days where everytime I stood up I started sweating, became nauseated and felt like I was going to pass out. So, I wasn't much help to him and it was very upsetting to me.

Today I'm doing better, plus I enlisted some help and it help to take the pressure off of me and I was able to lay down and rest today.

Today was Dan's 3rd follow-up check-up for his dog-bite and twisted left knee. It is Day #4 for the dog bite. He is still swollen and now the bruising is showing up. The doc said that before all was said and done even his foot would turn black. Right now his ankle is swollen and darkening in color. It looks like he has a sprained ankle. He is still having some drainage and of course the swelling. The news on his left knee is that he probably has torn some cartilage and he has a Dr. appt with the orthopedic surgeon on Tuesday. He remains uncomfortable and is still needing the pain pills. While the dog bite leg is improving, his left leg is not decreasing in pain at all. I feel bad for him, he is trying to put on a brave face, but I know that he is in a lot of pain.

I took some more pictures today. I will add them in a little bit.

This picture is of Dan taking his bandage off to change the dressing underneath.

I am uploading some pictures from yesterday, day two of Dan's dog bite. Notice the difference in the size of right leg from his left leg.

A busy day today. I had a Dr. appt with Dr. Li @ 12:30. The office was so shocked that Dan wasn't with me for my Dr. appt. We are going to keep my Aldomet at one tablet a day (that's the new drug). He agreed with me that holding my atenolol to every other day was not working and to keep taking 1/2 a tab every day. But, he does want me to stop the florinef. That is the drug that makes me to retain sodium and keeps my blood pressure up, I had only been taking it about three times a week.

My potassium is back up, he is concerned that it seems to drop so easily over the past three years. The florinef could be a factor. He wants to see what my potassium is in about 3 weeks. So, for now, I'm done taking the oral potassium. I go back to see Dr. Li in 4 weeks.

After my doctor appointment we had Dan's appointment. His leg is pretty swollen today clear up the thigh and the calf is a little swollen. But, there is not too much bruising, just the swelling. We need to keep watching it for signs of infection and cellulitis. That one tooth area is still oozing blood so we have a dressing on it. He is very sore and stiff, both knees. The left one is really swollen today on the inside.

I did call animal control and the dogs rabies shots are current, so we don't have to worry about that.

We are both really tired from all the stuff going on. He's not going to be able to go to work tomorrow, I hope some of the swelling goes down. He has been putting an ice bag on it off and all afternoon.

I took more pictures, I tried to show how much bigger his one leg is from the other, not sure if it will show up or not. I will post them later.

Wow, what a day. Dan was bit by a dog tonight, badly. We had animal control out here and the Sheriff's department. We had to take Dan to an Urgent Care center. We do not know the status of the dogs rabies, we will find that out tomorrow. The dog is in custody. Dan is on 4 prescriptions. He cannot have a tetanus shot as he is severly allergic to them. So, the doctor is very concerned about that. He said one area of the bite was deep enough for stitches, but because it is a dog bite and considered a dirty wound they are not stitched. Dan is still bleeding from that spot. In the process of being bit, Dan twisted to try and avoid it and they believe he snapped or tore a ligament in his opposite knee. The knee with the dog bite is extremely swollen. It looks horrible! He goes back to the doctor tomorrow afternoon.

So, he is on major doses of antibiotics, anti-inflammatories, antibiotic wound cream, and Vicodin for pain. What a mess.

There was a dog fight, Dan did not intervene. The other dog was making a lung at Ozzie, jumped over his back and nailed Dan. Dan was up against a car and could not get away from the dog. It was a huge yellow lab that wanders the neighborhood. Our neighbors across the street know where he lives, but not the the names of the owners. So, they gave the deputy the directions to the house. It is clear on the other side of our sub-division, not even close to us!

They owners are being cited for having a dog at large and will be required to pay quarantine fees. The dog must be quarantined for 10 days. And if his rabies is not current they will be cited for that as well. I'm not sure what that means for Dan. I would hate for him to have to recieve those rabies injections, they are awful.

Now, we just need to pray that he doesn't get tetanus!

The deputy also said that the dog owners are liable for Dan's medical bills because they let their dog wander at large. I hope that doesn't involve going to court. That would be an unnecessary stress on us.

Ozzie seems okay, although he is very upset that Dan was hurt. He just puked. He has a very nervous tummy for a dog.

Oh, and all of this happened while I was taking a nap! What a long day for us. We didn't get back from the Urgent Care until 9pm, that included a stop at the pharmacy, but they were waiting for us, so it didn't take long at all! We don't live in a small town, but they sure treat us like we are their only customers at the pharmacy!