Crediting doctors for his survival

Crediting doctors for his survival
Wound spawned flesh-eating infection

Written by
Steph Solis 

Perth Amboy resident Jack Dudas woke up one morning in January, five days after falling down the stairs, and found his leg swollen.
“My leg blew up literally overnight,” Dudas said. “I checked my temperature, and I had a fever.”
Dudas had developed necrotizing fasciitis, a flesh-eating infection that can be deadly if not treated in time. Paramedics told him that had he not called for an ambulance when he did, he could have lost his leg or died.
After three surgeries and an extended stay in the CareOne long-term acute-care hospital (LTACH) at Raritan Bay Medical Center in Perth Amboy, Dudas recuperated from the flesh-eating infection. His recovery exemplifies the deadliness of the rare disease, as well as the high chances of survival that only immediate medical attention can guarantee.
“When you get this infection, it is bad and you could end up with an amputation or die,” said Dr. Linda Neri, the surgeon who treated Dudas in the LTACH unit.
Necrotizing fasciitis could be caused by open wounds that become infected or bacteria such as MRSA that become active in the body after being stored forsome time, Neri said. It emits toxins that block blood flow from certain parts of the body, destroying muscle, fat and skin tissue. Those who are old or have conditions such as diabetes are more susceptible to developing the condition.
Doctors spent two months treating 24-year-old Aimee Copeland, a University of West Georgia student, after she was diagnosed with the infection. Copeland, who will be released in August, was sedated for several weeks and breathing on a respirator. She underwent several amputations and skin grafts to replace large patches of infected skin.
Copeland was diagnosed with the infection after suffering a deep cut in May after falling from a broken zip-line along the Tallapoosa River.
Cases such as Dudas’ are similarly life-threatening, Neri said. The medical team had to remove the pus from the leg wound and in the pockets of the muscle, leaving a hole that was 16 inches in diameter, 12 inches wide and 4 inches deep.
“Dr. Neri said it was so bad she could make a fist, put it into my leg through the hole and from the inside reach all the way up to my groin,” Dudas said.
After his surgeries, Dudas spent three weeks in CareOne’s LTACH unit, which treats people with complex illnesses and long-term conditions. Dudas, a former City Council member and longtime Perth Amboy resident, said he had not heard of the LTACH unit before.
'Over and above'
“I didn’t know there was a wound-care unit in the hospital,” Dudas said. “They went over and above. They got me a private room because of my (latex) allergies, and I was able to recover there from the point where I could go home and have visiting nurses.”

The 26-bed unit has more than 180 doctors who are credentialed across all specialties, said Mike Fancher, director of business development at CareOne. The unit’s nurses are certified registered nurses with Advanced Cardiac Life Support certification.
“These are patients who are very sick but have a great chance of getting better,” Fancher said. “The majority of patients that arrive at the CareOne LTACH recover very well here and are discharged either to a subacute facility or home.”
While in the LTACH unit, Dudas said, he had to be treated for the infection and have the hole in his leg closed.
The medical team used a negative-pressure suction device to remove the fluid from Dudas’ wound, Neri said. The negative pressure helped the hole close quicker.
“Even though it was a big defect in the skin and soft tissue, the body is very good at closing in when it gets the right wound care,” Neri said.
The nurses gave Dudas antibiotics and checked on the wound, helping him recover so he could be released on March 5. A nurse visited Dudas at home daily to change his bandages and check on the wound until June, he said.
The hole in Dudas’ leg has closed, but it will take a year for his wound to fully heal.
Acting fast is key
Neri said she saw about four cases of the flesh-eating infection at the LTACH unit this year. Most of the patients underwent operations and received antibiotics to stop the infection from spreading.
While Dudas’ case was more serious than the others, it shows how easily one can recovery if doctors respond in time.
“I think everybody really got on it right away,” Neri said. “The emergency room doctors made the diagnosis right away.”
Some signs of necrotizing fasciitis are high fever, inflamed skin and extreme pain and discomfort, said Richard Snepar, an infectious disease physician in East Brunswick. If there is swelling, it is imperative that the victim seek immediate care.
“The best way to treat this is rapid surgery,” he said. “If there’s any question, medical care should be sought immediately.”
However uncommon the infection, Snepar said, it becomes more difficult to control if it is not addressed immediately.
“The shame is when there is a delay because it’s hard to recover the patient,” Snepar said. “When a patient gets in, we do see a delay in treatment, and that’s for the patient’s detriment.”
Most people will never experience necrotizing fasciitis, Snepar said. What matters, however, is that people do not make the mistake of ignoring the signs.
“It’s very sporadic and serendipitous when it does affect an otherwise healthy host,” he said.


July 27, 2012 | Posted by careone | Filed in News