Hi Dana... I hope you don't mind, but I'm replying to your message on list as well as directly to you because I think it's very important people understand why I intentionally wrote things the way I did. (You originally posed the question off list).
You asked, "Why do you say we hope?" The reason I used "we hope" and "hopefully" with regard to eradicating the MRSA-related osteomyelitis I have, has a lot to do with my experience with biology... my major, the subject I teach, and how the medical community is beginning to regard this bacteria. MRSA, as with any infection, is only "cured" when every single infectious bacterium is killed by whatever means you're using in conjunction with your own immune system. Most antibiotics work by killing enough bacteria to allow your immune system to kill or "learn" to kill the small amount remaining. MRSA in particular is difficult because of its ability to quickly mutate... though not as quickly as something like AIDS. And I want to note that the CA (community-associated) MRSA is more virulent than the HA (hospital) strains, meaning CA spreads and mutates more quickly. MRSA, especially located in bone where blood flow --and therefore the reach of antibiotics and an immune response-- is lessened and is much more difficult to completely eradicate... AND difficult to confirm. Most of the time a person who once had MRSA is considered to be (at least in a hospital setting) "a former MRSA patient" and many additional precautions are often... and usually should... be followed, even to the point of requiring every person entering that patient's hospital room to put on gloves and a disposable isolation gown before entering and then disposing of them each time they leave the room. This happens not only when a person has MRSA but also when someone has a history of MRSA. It's one aspect of controlling the spread of the bacteria to another person or even just to another object where another person may come in contact with it. In that respect, MRSA is somewhat like a cancer. Typically, someone isn't usually clinically defined as "cured," just like someone who had cancer is considered in remission, not necessarily cured, just because it's far too easy for MRSA to mutate and become resistant to whatever antibiotic or combination of antibiotics you might be taking while also becoming dormant in nearby tissue ready to begin a new infection. A person might appear to be cured as far as no symptoms or cultured signs of the bacteria being found. But a real CURE as we typically define it (i.e. all bacteria gone) is difficult to be certain of. Even if only one bacterium remains in a dormant state, it can be "reactivated" by a weakened immune system or any other number of factors. Because it only takes a very small number of bacteria to begin a reinfection of an area it's almost impossible to definitively say it's all gone. Even in a wound culture using a swab of an entire wound has the possibility of missing a single small colony that could take up an area smaller than a pin prick. So, the culture comes back negative even though the bacteria is still present in your tissues. By all means, I am NOT saying it isn't cured or CAN'T be cured... I'm just saying the possibility for missing a potential infection exists. To answer your question specifically regarding the reason I keep saying "hopefully" when I'm referring to myself and my situation, I had what's called refractory osteomyelitis with MRSA. Refractory osteomyelitis is a bone infection that remains after all other antibiotic and surgical options have been exhausted. MRSA, a gram-negative anaerobic staphylococcus CAN be killed. The difficulty is in determining whether it has all been killed or not. It's almost impossible to tell for certain... especially in more dense bone tissue where blood flow is limited. You are correct in that I did learn these things in a way I wouldn't choose. However, because I learned them this way and because of my general knowledge of biology plus several friends who are doctors who have had to deal with this, I would have to say what I've learned is quite accurate. (Not to sound arrogant.) I hope that answers your, and some others', questions. (BTW: Do me a favor everyone, and stay away from this crap if you can!) Best regards, --Tod ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Tuesday, April 08, 2008 1:52 AM Subject: Re: [QUAD-L] MRSA Hi Todd, Why do you say we hope? You have really gone through a lot. You have learned a lot but not the way you would like to. We don't like to experience the problems of SCI to be knowledgeable, but that seems to be the way it happened. I sure hope everything heals properly for you. I'm glad to have you back on the list. Dana ------------------------------------------------------------------------------ Planning your summer road trip? Check out AOL Travel Guides.
