Fight for life after dog bite evolves into battle to regain mobility

Published 7:32 am Friday, October 23, 2009

Mike Moore heard his two dogs, Ember and Sadie, barking and fighting, and rushed to see what was wrong.

He reached down to grab Sadie, a brown Labrador and blue heeler mix, to try to break up the fight. “She just let go of the other dog and nipped me, like maybe she thought it was another dog,” Moore said.

Moore looked down and found a bite mark near the thumb on his right hand. “Just enough to make it bleed,” Moore said. “Damn it!”

He walked inside his house in Granite Falls to rinse off the wound and put some bandages on it.

“No big deal,” he thought.

Two days later, on April 28, Moore was at his job at Spencer LLC, a Monroe cabinet making company. Just before the end of the day, at 3 p.m., he started feeling sick. He walked into the company’s finishing room, where shellac and polishes are added to the woodwork, to turn up the heat.

“I was so cold, I couldn’t get warm,” Moore said. “I thought I had the flu.”

At home the next morning, he called out to his partner, Karin Coleman. “I told her I needed to go the clinic; something was wrong,” Moore said.

She called the clinic and was told Moore should go straight to the emergency room. His son, Levi, got him out of bed. Moore dressed, putting on his shirt, shorts and sandals.

“As soon as he got me in the light he said, ‘Oh Dad, you look like crap,’” Moore said. Unknown to Moore, his face and body had a bluish tint.

When they arrived at Providence Regional Medical Center Everett, Moore, 47, was put into a wheelchair and rushed to the emergency department.

Four people were in line ahead of them, waiting to be admitted. “Please, something is just not right,” his son said. “Can someone look at my Dad? He’s really sick.”

Moore was wheeled into an examination area. Hospital staff began asking a string of rapid fire questions:

Why are you here?

“I’m hot,” Moore managed to reply. “No blankets, please.”

They asked about the scar near his stomach.

“I told him my spleen had been removed.”

They asked about the bandages on his right hand.

“I said I had a dog bite the other day.”

“Then I faded out,” Moore said. “I don’t remember anything for the next one-and-a-half weeks.”

***

The doctors and nurses who surrounded Moore couldn’t pinpoint what was wrong with him. But they did know this: He was on the verge of death.

His blood pressure was so low, they couldn’t get a reading.

The major organs of his body were rapidly weakening and failing, one after the other, their function flickering like an incandescent light bulb just before it goes dark.

His kidneys shut down. His liver, blood vessels, heart and lungs were on the verge of failing.

He was given two medications to boost his blood pressure to try to reverse his downward spiral.

Meanwhile, doctors began trying to piece together the puzzle of Moore’s problems.

They had two hints: the dog bite on his hand and the scar on his abdomen.

By the time he arrived at the hospital, the bite — actually two puncture wounds on either side of his right hand — was so infected, doctors initially worried he had flesh-eating bacteria, said Dr. George Diaz, an infectious disease specialist at Providence.

Dog bites happen to many people, and for most, a little soap, water and a quick medical check is all that’s needed.

But the roll of the dice wasn’t in Moore’s favor. His Lab and heeler mix, Sadie, like an estimated 16 percent of dogs, had a type of bacteria in her mouth with a tongue-twisting name: capnocytophaga canimorsus.

That was bad enough. But Moore’s problems were further worsened because of the previous surgery to remove his spleen, which weakened his immune system. In such cases, the resulting infection from a dog bite can be fatal in about a third of all cases, according to the Ontario Veterinary College, part of Canada’s University of Guelph.

Infections in patients who have no spleen often are very severe, Diaz said. And the longer a patient waits to be treated, the worse they do.

Doctors know about the types of bacteria that grow in the mouths of animals like dogs and cats, Diaz said. That, paired with a weakened immune system, helped them piece together the string of events that had caused Moore’s sudden, life-threatening illness.

Their hunches were confirmed by blood tests. Generally, it takes about 24 hours for the bacteria to grow enough to be identified. This time, they didn’t need to wait.

“They could see the bacteria in his blood,” Diaz said, “which is very, very unusual.”

***

Moore was transferred to the hospital’s intensive care unit. As it turned out, the fight for his life had just begun.

Moore’s problems were caused by a severe blood infection, called sepsis, and the shock it caused to his body. Overall, it took 10 physicians to treat him, including kidney, bone, nervous system and blood vessel specialists.

Moore was put on a ventilator to help him breathe and given powerful sedatives to keep him still and give him time for his body to heal.

His condition grew even more fragile about a week after he was hospitalized. His temperature hit 105 degrees. His body swelled, a byproduct of the intravenous fluids and medications he was given to control his blood pressure. The bacterial infection also had radically altered his skin tone.

“I was big, blue and purple…and so bloated I looked like a blow-up doll,” Moore said.

His body was bathed in ice to try to break the circuit on his out-of-control fever.

At one point, Moore was given a 10 percent chance of making it though the night. Even if he did, his family was told, his fever was so high it could cause heart, brain and lung problems.

“That night….” Moore begins. “That’s what really, truly gets me the worst. I was so close to being zipped up in a baggie and sent to the morgue.”

Instead, somehow, his body fought back. Moore soon had a nickname among hospital staff: The Miracle Man.

“You cut yourself, you step on nail, you do all kinds of weird things,” Moore said. “One simple, small thing with a dog breaking your skin and you almost die from it.”

Moore doesn’t blame his dog for what happened. “I actually blame myself,” he said. “The dog did what the dog does naturally. I didn’t know better.”

***

Moore spent a month at Providence, most of it in the intensive care unit. When he left the hospital on May 29, his kidneys were so weak he had to undergo dialysis three times a week.

The infection had severely damaged his hands and feet, “which were dying, black and mummifying,” Moore said.

“If you’ve ever seen frostbite, that’s how my hands and feet looked, but 10 times worse. They were hard as rocks. You could bang on them and it was like pounding two pieces of wood together.”

When he tried to stand up to walk, the pain was so extreme Moore said he almost wanted to cut off his feet himself.

In July, he went to Harborview Medical Center in Seattle for a series of amputations and operations.

His right hand had to be cut off it. His legs had to be amputated below the knee.

Even his left hand had to have three fingers removed, the pinkie, ring finger and three-fourths of his index finger.

The two remaining fingers on his left hand didn’t escape unscathed, either. The tips had to be removed to take out deadened skin.

As he was about to be wheeled into surgery, he said he lifted both hands one last time, symbolically waving goodbye to each of them. “My hands were the hardest to lose,” he said.

Moore’s steely spirit of self-reliance helped him adapt to all he has had to endure.

Family friend Sharon Christensen said that spirit began before Moore even left the hospital. Determined to answer his own phone, he had someone tape his cell phone to his pillow and used a tongue depressor to press the answer button.

He had Velcro strips added to the bandages on his hands so he could begin to learn to feed himself.

“He’s very resourceful,” Christensen said. “He likes to be able to do for himself.”

Since coming home, Moore has tackled one task after another, psychological mile markers on the road to regaining independence.

He’s learned to open a can of pop with his front teeth. He’s figured out how to shower and wash his hair.

Moore, a natural lefty, has enough gripping motion in that hand to spread shaving cream on a counter top and then apply it to his neck, and by using Styrofoam to stabilize his razor, is able to shave.

Two sets of seven stairs separate his bedroom from the upper living areas of his home. Many people might curse the obstacle. Moore calls them “the lucky sevens” — crawling up the stairs and clambering down them on his knees.

Intense self-reliance, though, can have its drawbacks. It makes it hard to accept help, Moore said.

“I was too proud to take help,” he said. “I’ve gotten over that hump … If anyone wants to help, I won’t turn them away.

… I’ve learned how to be humble.”

***

There is one final, Joblike, twist to this story. It began in February, about two months before Moore was bitten by his dog.

Karin Coleman, Moore’s partner of seven years, felt a lump in her right breast. She delayed going to the doctor, hoping it would go away.

Coleman, 42, didn’t tell anyone, not even Moore, until a biopsy was completed in March, confirming that she had cancer. Surgeons removed the lump in her breast and two lymph nodes in her right arm.

After her first chemotherapy treatment, which occurred the day before Moore was taken to the hospital, Coleman confided that she wasn’t sure if she was tough enough to make it through the treatments, her nurse, Arlene Englebright recalled.

Yet Coleman faced her treatments with a positive attitude, Englebright said, and only got sick once.

What people who meet Coleman seem to remember about her is her calm assurance and smile.

It’s not until she momentarily lifts the baseball cap she wears to warm her head, allowing a glimpse of the tell-tale “chemo stubble” of a hair regrowing from cancer treatments, that her own medical battles are hinted at.

While such medical adversity — combined with the responsibilities of raising four children from their blended families between the ages of 16 and 22 — could split many couples apart, they say it instead has brought them closer.

Coleman smiled, looking at Moore, as she tried to explain it. “Taking care of you in some weird way has made me stronger in what I’m going through,” she said.

Coleman’s cancer treatments continue, but have been complicated by the news that her sister has been diagnosed with breast cancer, too.

Tests showed her sister has a genetic mutation that puts her at greater risk for ovarian cancer and a recurrence of breast cancer.

Coleman had been planning to begin radiation treatments, but her doctor suggested they delay them until she, too, could be tested, since additional surgeries might be necessary.

Neither Coleman nor Moore have private health insurance. Both are on Medicaid, and the request for Coleman’s genetic testing has been at least initially denied, Englebright said.

In Granite Falls, word of the family’s plight has quietly spread. Christensen said she has thought of trying to organize a benefit concert. But she worries that any help from the community could jeopardize the family’s ability to stay on Medicaid.

The government program helps pay medical bills, but has income restrictions.

“Karin can’t work because of her breast cancer,” Christensen said. “Obviously, Mike is not able to work. Their savings are long gone.

“Medicaid is a great step up, but it doesn’t pay the rent, food or utilities.

“What more can this poor family deal with?”

***

Moore was fitted with two prosthetic legs in mid-September, their components made of aluminum and carbon graphite. A device called a torsion adapter allows him to pivot his legs, as he demonstrated during a recent check-up at an Everett prosthetics clinic.

“Look!” Moore said, raising his arms and swiveling. “I can actually do the twist!”

Christie Goehle, a clinic employee, asked Moore to make trips up and back, between two balance bars, to check his gait.

“I’m a quick learner,” Moore said. “The doctor told me I wouldn’t be walking on my own for six months.”

Goehle, though, spotted a slight hitch in his stride. Moore agreed. “Kind of like the front-end alignment is off on your car,” he said.

She used a small tool to make a slight adjustment and marveled at his progress. “You are exceptional,” she said.

At the end of their session, Moore, never content to simply enjoy his progress, started resetting the bar of his expectations.

“I’d like to ride my motorcycle again and use the stick shift in my car,” he said.

Before the accident, “I never would sit home when I had time off. Just do, do, do.

“I used to love playing softball. I loved working in the yard and taking the dogs for walks. With wintertime coming I would love to grab my chain saw.”

Perhaps most of all, Moore hopes to resume life’s familiar routines, of getting up and going to work, of returning to his job at the cabinet company in Monroe.

“I’m hoping before Christmas,” Moore said, but he has to have time to recover from the final surgery on his hand, which took place on Thursday.

His boss, Carl Spencer, already has a job in mind for him, production manager. “We’re ready,” he said.

Moore’s tasks would require him to work at a computer. Once again, Moore is pushing himself, thinking about the next step.

“I’ll finish my daily tasks and then I’ll be out on the floor,” he said. “I don’t like to sit in the office. I like the smell of sawdust.”

It was just by chance that Moore learned how long those familiar smells have been part of his life, evoking childhood memories.

One day, his boss brought in some walnut boards to be cut up and used for sample doors.

“It brought back memories of this huge walnut tree I had in Everett that I used to climb up in and pick the raw walnuts,” Moore said.

“When you run walnut through a machine, it smelled exactly like my hands did then. I just paused with that smell and had the flashback of me being a kid again.”

Sharon Salyer: 425-3393486, salyer@heraldnet.com.