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Patient Stories: Brandon Noble

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Former Washington Redskins defensive tackle who had recurring serious MRSA infections in his knee.

Being a football player, there are certain things you can expect to deal with. From high school in Virginia Beach, Virginia, to college at Penn State, and into the NFL, I have had broken bones in both hands and my leg, had concussions (probably more than I care to know about), stingers (where you go from not being able to move your arms to an incredible burning sensation), separated shoulders once or twice, torn tendons off of the end of my ring finger, torn ligaments, and dislocated my knee cap, on top of the usual wear and tear, arthritic joints, jammed fingers, bruised muscles, sprains, smashed fingers and stepped-on toes. But the worst and most unexpected thing that I have come up against in my football career (I have been playing since the age of 14 and I am 31 now) has been a tiny little thing that I cannot see. It has hurt me more than any of the others combined and had a hand in ending my career: methicillin-resistant Staphylococcus aureus (MRSA).

In April 2005, I had a routine operation to clean out my right knee. The usual wear and tear of football had caused some cartilage to chip off and was floating around in my knee causing swelling and stiffness. By getting the surgery in April I felt like I would be able to be fully recovered and ready for the upcoming season. The surgery was performed, and I was fine for about eight days, then the stitches were taken out. That night, a hot spot developed over the porthole used for the surgery. I began feeling sick—flu-like symptoms and my knee hurt like someone was lighting me on fire. By the time I was put in the hospital, the infection had spread from a quarter-sized red spot around the port to cover a good portion of my leg. It had taken about two days. One of the first doctors that I saw told my parents that if I had waited another 24 hours we could be talking about the loss of my leg or worse. Surgery was performed, and things got better once the infection was washed out.

But now I had to deal with the rest of the treatment, which included a peripherally inserted central catheter (PICC) line for take-home IV treatment for six weeks on the drug vancomycin. A PICC line is basically a tube that is inserted into your body so you don't have a traditional needle IV in you for six weeks. This antibiotic will wear you out. Besides the fact I was told not to lift anything over 5 pounds with my arm that had the PICC line in it, the vanco exhausted me, sapping my energy and appetite. I am married with three kids (two at the time), none of them are under 5 pounds, and not much else in this world is. So, that limits you in itself. Three times a day, for an hour and 30 minutes, I had to sit down and get my dose of vanco. Then I got Redman Syndrome, which happens when you administer the vanco too fast: a very itchy rash that will drive you crazy and turns you red. So, I was taken off of the vanco and placed on linezolid. This is an oral med that is very strong and gives you jock itch everywhere that is dark and warm. I will leave the rest to your imagination. I completed my treatment and was given a clean bill of health

I had at this point missed the entire off-season workout program due to the way that I felt from the antibiotics. Now I was playing catch up and tried to cram an off-season into three weeks. I was able to come back and play during preseason camp, but in compensating for a weak right leg (the one that had been infected) I hurt my left leg. I chipped off some cartilage and suffered a bone bruise requiring surgery again. I was placed on injured reserve and forced to sit out for the season.

While all this was going on we found out that my wife was pregnant with our third child. So, since I was on injured reserve I was able to stay home and help my wife out. Chasing the kids around all day I re-injured the bone bruise, which caused a gross amount of swelling in my left knee. I had the knee drained numerous times, but each time the swelling came back. In December, after draining my knee two or three times in about two weeks, I started to get sick again. Same symptoms as before—burning in the knee and the worst flu symptoms you can imagine.

I was admitted to the hospital on Dec. 15 for surgery to clean out my knee. The next day, Dec. 16, my wife was admitted to the hospital, and our third child was born. I was in the delivery room thanks to an understanding doctor. Because of my MRSA they were hesitant to let me in the delivery room (understandably so), but my wife's doctor said that as long as I washed my hands and stayed clear of the actual delivery, I could be there. I would not have taken it well had this not worked out. Missing the birth of a child is not acceptable to me and would have been devastating. I was scared to hold him for fear of getting him sick. It is tough not to hold your child right after he is born. I was sent home with another PICC line in my arm on the antibiotics daptomycin and ciprofloxacin, an oral medication, because the culture was not growing. I was being treated for MRSA and whatever ciprofloxacin kills.

My PICC line is out now and I am done with the ciprofloxacin. I am taking a suppression medication called doxycycline for at least 6 months. And then I think I will be tested to see if MRSA is still on/in me. The thing that scares me the most is I could be a carrier of this bug and have to worry about my wife and kids getting it. Knowing how painful and serious it is, that is the last thing I want to happen. I have two boys, the oldest is 4 and hell on wheels. If his little brother is anything like him, it will be a lifetime of cuts and scrapes. I will keep a close eye on each one because I am incredibly paranoid about them getting MRSA. Any small red bump on any of my kids and I am pestering my wife to keep an eye on it, ready to go to the doctors at the drop of a hat.

An unwelcome complication from my last surgery was developing two blood clots, one in each lung, and I am now on blood thinners for at least 6 months. Because of the clots and the MRSA there is a very good chance that I will never play football again. This infection has had a huge impact on my life and will continue to impact me and my family in the near future. Hopefully, I am not a carrier and will not have to worry about this forever. Regardless, I will be vigilant in watching every cut and scrape that my kids get because I don't want them to have to suffer the way I did. To say that the last year has been difficult for me and my family would be an understatement, and we have MRSA to thank for it.

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