Mother's Day: HIV and ID Observations...

Tornado watch: Tornado watch issued for parts of New Hampshire, Maine, Massa...
Published Time: 11.05.2024 - 15:45:16 Modified Time: 11.05.2024 - 15:45:16

(I’m terrified of ladders. My wife thinks I’m a wimp, but I know better.) Mother's Day

By way of background, my mother regularly uses New York City’s public transportation system, both the subways and buses. No big deal, one might think, so do umpteen million others. But the reason I mention it is because my mother is old. How old? Just look at me, and do the math for a good approximation. To be specific, she’s to start her tenth decade.

We’ve all seen what falls can do. And it’s not just to older — I’ve taken care of a man in his 30s whose life was irreversibly changed after falling from a ladder in his kitchen, striking his head, breaking his ankle, and triggering a series of neurologic and infectious complications that left him permanently impaired.

(I’m terrified of ladders. My wife thinks I’m a wimp, but I know better.)

Of course when it comes to falls, older are especially vulnerable. Neuropathy, muscle weakness, vestibular instability, visual impairment, osteoporosis, and arthritis all come together to make falls way more common — and treacherous — in us as we age. The falls cause physical and psychological trauma that can profoundly weaken a person, leading to an amplifying cycle of debilitation and complications and dependency.

Think how many times you have heard, “He was ok before the fall …” or “Ever since the hip fracture, she’s never been the same.” Shudder.

In my conversations with my mother after the event, the tone of fragility in her voice was one I had never heard. Plus, she was barely leaving her apartment.

But rally she did:

So we finally come to the ID part of this post. When the healing seemed to be slowing, with increased drainage, her plastic surgeon sent a wound culture, results of which he shared with me in this screen shot:

“Unless you have another thought, I’m going to start levofloxacin,” he wrote to me. Yes indeed, good plan — it was a superinfection of this widely open wound. Perhaps it was selected by the previous course of cephalexin she took. Or maybe it was just a “gift” from the flora of the New York City streets.

Ever curious, my mother had two questions, my answers in brackets:

Is this the infamous “flesh eating” bacteria? [No, that’s most often strep.] If this is a pseudo (meaning fake) monas, what’s the real monas like? [I have no idea.]

These are excellent questions, especially the second one.

I’m happy to report that with local care, and antibiotics, and time, the wound has ever-so-slowly healed. She’s “graduated” (her term) to just using a small bandage. No more visits to Dr. Schwartz.

So Happy Mother’s Day, Mom — glad you’re getting better, you did amazingly well. And be careful on those city buses!



Save my name, email, and website in this browser for the next time I comment.

Note: This is a moderated forum. By clicking on the "Submit Comment" button below, you agree to abide by the NEJM Journal Watch Terms of Use.

Our physician bloggers cannot respond to requests for personal medical advice, and recommend patients discuss health issues with their individual physicians.


This site uses Akismet to reduce spam. Learn how your comment data is processed.

HIV and ID Observations.

Copyright © 2024 Massachusetts Medical Society. .