Flesh-eating Bacteria Survivor
by Vance “Bo” Salisbury
It’s been over seventeen years now, since my family and I were brought to the precipice of sudden death, fear, confusion and loss from a murderous intruder, lurking unseen within my own life-giving blood. On May 9, 1998, while playing indoor soccer with folks from our church, I was kicked in the left ankle. The following day, Mother’s Day, I followed my routine and woke to take our dog Rosie for a walk before church. At about 10 AM, my ankle began to hurt and by 11:30 AM I was in severe pain. Someone offered aspirin, I took it and we joined our friends, the Richeys, for lunch at Fred’s Chinese Restaurant. At about 2 PM I could no longer stand the pain and went to the local Emergency Room with my wife, Denise, and friend Mark Richey, a radiologist. The ER doctor examined me and it appeared to be a routine sports injury, so I was released and given some prescription pain reliever.
The following day, Monday May 11th, I was still in terrible pain and the ER nurse told Denise to double the dosage and make me as comfortable as possible. By that afternoon the pain was unbearable, I was nauseous and crawling from room to room, because I was losing energy and strength. What we did not know was that my life was beginning to fade away. Denise called our family physician, Dr. Scott Kellermann, who told us to come to his office immediately. By this time I was perspiring and my blood pressure was dropping. Scott admitted me to the local hospital where I was observed and tests were taken through the night. The following morning I went into shock, began experiencing multiple organ failure and was to be transferred, via helicopter, to the UC Davis medical center in Sacramento CA. However, a late spring storm bringing snow kept the helicopter grounded, so I was taken by ambulance.
When I arrived at the UCD ICU, Dr. Susan Murin was the attending physician. She and Dr. Jeff Jones interviewed my wife and I, resuscitated me, inserted the various catheters and the breathing tube. At this stage, my leg was mottled and still presented as an athletic injury. But, why were my organs failing and how did that relate to my leg? Dr. Jones made the diagnosis of necrotizing fasciitis, but he was in the minority and the surgeons on hand were skeptical — until the blood work arrived from my local hospital, confirming his opinion. Dr. Murin later told me that Dr. Jones was heard gloating “I’m the man” for the next few days, because he was the first to put the clues together and make the diagnosis. My case was turned over to the world renowned surgeon and “father of modern trauma care,” Dr. F. William Blaisdell.
Dr. Blaisdell and his team put me on a powerful combination of antibiotics and began debridement of my leg, removing soft tissue down to the muscle in five separate operations. I spent ten days on the ventilator and was in a coma for most of that time. To be certain that all of the bacteria was gone, the flesh was removed from the top of my toes to the top of my left hip and it was discussed whether my foot should be amputated or fused at a 90º angle, because there was literally nothing left between my ankle and Achilles’ tendon. Experiencing septic shock, with indications the infection had spread into the soft tissue in my lower back, I was expected to die. The bacteria marched up my left leg, destroying all of the soft tissue down to the fascia (the membrane between the muscle and outer soft tissue). My condition was grave for some time and amputation of my left foot and leg became a very real option. You may view the post-operative photos, but they are very graphic.
I was transferred to the Burn Unit ICU, Dr. Kellermann canceled all of his appointments for four days and joined my friends and family at the hospital in fasting and prayer. People all around the world lifted me up to Jesus and He answered those prayers by saving my life and performing a few miracles.
On day four, the bacteria halted at the top of my thigh — Dr. Kellermann believes it was a miracle. That day, the surgeon brought Dr. Kellermann in to show him that the infection had moved all the way up into my lower back. The outside border and time of the examination had been written on my skin with an indelible marker. “We are taking him in for a final debridement, but he is not going to live. It’s like trying to stop a freight train with wet tissue paper,” the surgeon confided. One of the nurses in the burn unit ICU gave my wife the same grim prognosis, motioning with her hand up the left side and lower back. Denise only remembers the conversation, but not what was said. She did not understand, at that point, that my death was virtually assured because of the size and location of the infected area; She thought the nurse was simply keeping her updated.
Two hours later, the surgeon emerged from the elevator and sat down with everyone in the waiting area. “I’ve been a surgeon for many years,” he softly said, shaking his head over and over. “I’ve never seen anything like this. We searched for hours and the infection is completely gone.” Dr. Kellermann cast all sense of professional propriety aside, and began leaping and shouting down the hallway, “Praise the Lord!” Scott gathered everyone together for a prayer of thanksgiving and as he recorded, along with the rest of these events in his journal, “We talked about how a miracle had been witnessed by us today and from this time forward, Bo’s life and all our lives would be forever changed.”
I remained in my coma that evening, while Denise and friends celebrated with a feast and belly dancing (tongue in cheek)! Taking this sudden change of events as a sign that things were turning around, they decided to dine at a Moroccan restaurant near the hospital. What they didn’t know was that belly dancers entertained the customers every night at 7:30 PM. So, as my family and friends broke their fast on gyros, roasted chicken, flatbread, couscous and yogurt, middle-eastern music suddenly blared from speakers and two belly dancers came swirling out of the kitchen, gyrating around their table. Back in the burn unit ICU, I continued on in my morphine induced, Dali-esque dream world. Looking back, I always find that so amusing. My friends staggered out of the ICU to find refreshment after struggling with death for four days and stumbled into a restaurant, which celebrated day-to-day life through belly-dancing (un-advertised and unannounced).
I had eight skin graft operations in all, shaving skin with the Dermatome from my entire body, except head, arms and a strip up my back, so that I was almost completely “skinned” at one time. Skin was harvested three times from my stomach over the course of my stay at UCDMC. Dr. Kellermann was amazed at the success of the grafts. When 40% of skin grafts take, that is considered exceptional. 90% of my grafts took the first time! Dr. Kellermann remarked, “I don’t know what they [the surgeons] would call it — I call it a miracle.”
My ankle was still in trouble after most of my leg had been grafted and reconstructed. The plan was to release me from the hospital to go home, where I would gain back some strength and return to have the plastic surgeon perform a flap to fill in the big hole in my ankle. Dr. Blaisdell summed up the situation in these words after my weekly Tuesday surgery; “his tendon is hanging in the breeze.” However, the Lord touched my ankle and when my cast was removed five days later, everyone was amazed to find the tissue had quickly and miraculously “granulated” from my ankle and was touching my tendon — an occasion for rejoicing by all the nurses in the Burn Unit and surgeons, Dr. Kathrin (Mayer) Troppmann and Dr. James Morrison. The rest of my leg was making good progress by this time: my foot and ankle were spared.
After five weeks, I was in the trauma ward and Dr. Jones popped his head in the door. “I just had to meet you,” he exclaimed. “I’m the one who intubated you, when you came into the ICU. I was surprised when I kept seeing your name come up on the surgery roster.” As far as he was concerned, I was a dead man! Later, Dr. Murin informed me of a sort of “Murphy’s Law” of medicine; She and Dr. Jones thought Denise and I were a nice, cooperative couple when I was admitted to the ICU — therefore, I probably wouldn’t survive! Generally, it’s the ornery and combative patients who make it.
When I was released from the hospital in August, the plan was to gain strength and return to close up a hole the size of a quarter exposing my tibia, patch a spot on my Achilles’ tendon and have the plastic surgeon perform releases, which would certainly be necessary around my joints. Well, the home health nurse was amazed when my tibia closed overnight and half of the open areas on my thigh healed! Later that week, Dr. Morrison seemed disappointed that the tibia had closed up on its own. The week before, he pointed to the wound and remarked: “that spot there is just crying out for me to drill some more holes.” Months before, during the reconstruction and grafting of my lower leg, holes were drilled to the marrow in the tibia to create a blood supply for the tissue to grow over and he was anxious to try it again! As time passed, my skin grew so well and was in such good condition, I did not require further surgery. Hallelujah!
I was at UC Davis for three months. I laid completely still on my back and became totally deconditioned, to the point that I could not stand for more than a few seconds without becoming nauseous or fainting. My brachial plexus was damaged, so my right arm no longer worked. I began rehabilitation in late July, was released in mid-August and returned home. In the early stages of reconstruction, Dr. Blaisdell told me that I would not have any range of motion in my ankle and would walk in a wooden way. I am happy to report that my ankle is fully functional, though I lack a few degrees of dorsiflexion. I achieved my ultimate physical therapy goal by getting up on my surfboard. However, it was very difficult because of the injury to my arm, so I sold my board and bought a body board. I began running and on June 2, 2002 I ran in the Gold Country Races 5k with Denise. I finished 13th overall and won a third place medal in my division (duffers and geezers). I am now running about 20-25 miles a week, non-competitively. I was able to travel with my daughter Emma to Uganda in 2000 and again in 2001, where my leg was a wonder to all! We met Dr. Kellermann and his family there, treated people in makeshift medical clinics, ministered to children in orphanages and trained local pastors. Scott and Carol Kellermann went on to found and build their own hospital in Uganda! I was able to return to work as a Postmaster after 8 months and, although it was often physically difficult, the US Postal Service was very accommodating and supportive. I continued on until retirement with 39 years on my birthday in 2014. I also returned to pastoral work, recently completing 24 years of bi-vocational ministry. I praise and thank God for His grace and mercy!
A Rosey Picture
Since my story appeared on the Web, I have received hundreds of comments; most have been very favorable. Once in a while, someone will write to insist that my survival and recovery were more likely the result of excellent medical care than divine intervention. They feel that I am slighting the people who worked so hard to save my life, by attributing so much to the mysterious workings of God. Whether or not I was saved by miraculous or divine intervention is up to you, the reader, to decide. I remain convinced that I was spared by God’s grace, through both miraculous and “ordinary” means. By “ordinary,” I mean the extraordinary skill and efforts of the healthcare professionals, who cared for me and encouraged my family and friends through the entire ordeal. I am grateful to have had the best surgeons, physicians, nurses, physical/occupational therapists, friends and family in the world! All played a big part in my recovery and it is my goal to improve on the investment of their time, years of training, hard work, emotional involvement and material support. Throughout my stay at UC Davis, I was in continual awe of the professionalism and work ethic of everyone there. Denise and I continue to stay in touch with a number of the surgeons, rehab doctors and nurses. Some have been featured along with us on the Discovery Health Channel and Dr. Murin is the subject of a chapter on medical professionals in a recently published book by Scholastic.
I will occasionally receive an angry message from someone who has lost a friend or relative to necrotizing fasciitis. They feel that I am presenting an overly rosy picture or that I really cannot comprehend the pain they are suffering in their loss of a loved one. Others think I got off pretty easy, because of the good results I’ve seen and because I didn’t lose any limbs. First, let me say that I have a number of fairly serious, lingering health problems, which resulted from this experience and I will be talking about those in blog posts and other pages. And, I have lost loved ones to other horrendous diseases or conditions and experienced grief. It may not have been as great or debilitating as what others have gone through, but that does not diminish my desire and sense of responsibility to offer what little bit of compassion and understanding I can to those affected by NF. I think it is best to accentuate the positive in my experience and give as little space as possible to the many physical problems that remain, as a result of my bout with NF. I have chosen to dwell on the successes and to seek a positive outcome from this catastrophic experience. I encourage others to strive to overcome the ravages of this deadly disease and not remain its victim, like many I hear from who are doing well. Their prescription goes something like this: “This kind of experience will either make you a bitter person or a better person.”
Job 19:25 – 27 And as for me, I know that my Redeemer lives, And at the last He will take His stand on the earth. Even after my skin is destroyed, Yet from my flesh I shall see God; Whom I myself shall behold, And whom my eyes shall see and not another.