Flesh-eating Bacteria Survivor
by Vance "Bo" Salisbury
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 usual routine, taking 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. I took some aspirin 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
, a radiologist. The ER doctor examined me, but it appeared to be
a routine sports injury, so I was released and given some prescription pain
The following day, Monday May 11th, I was still in terrible pain and the
ER nurse told Denise to double the dosage of pain medication. By the
afternoon, the pain was unbearable, I was nauseous and crawling from
room to room, because I had no strength. 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 hospital where I was observed and
tests were taken through the night. The following morning I experienced
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.
was the attending
physician. She and Dr. Jeff Jones interviewed my wife and I,
resuscitated me, inserted various catheters and the breathing tube. Dr.
Jones made the diagnosis of necrotizing fasciitis, but 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 make the diagnosis based upon the symptoms.
My case was turned over to the world renowned surgeon and "father
of modern trauma care
F. William Blaisdell
. He and his team put me on a powerful
combination of antibiotics and began debridement of my leg, removing
everything 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.
I went into toxic shock and 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 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 a 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 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. At the time,
Denise could not comprehend 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 "Praise the Lord!" Scott gathered everyone together
for a prayer of thanksgiving and as he recorded 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! Taking this sudden change of events as a
sign that things were turning around, they decided to go to dinner at a
local Moroccan restaurant. 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 began blaring and two belly dancers
came swirling out of the kitchen and gyrated around the table.
Ironically, I continued on in my morphine induced, Dali-esque dream
I had eight skin graft operations in all, peeling skin with the
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 removed
three times from my stomach. Dr. Kellermann was amazed at the success of
the grafts. When 40% of the 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. The
plan was to release me from the hospital, gain back some
strength and return to have the plastic surgeon perform a flap
in the big hole in my ankle. Dr. Blaisdell summed up the situation in these
words; "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,
Kathrin (Mayer) Troppmann
and Dr. James Morrison. The rest of my leg was
making good progress by this time.
After five weeks, I was in the trauma
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 "Murphy's
Law" of medicine; She and Dr. Jones thought Denise and I were a nice,
cooperative couple -- therefore, I probably wouldn't survive!
When I was released from the hospital in August, the plan was to gain
strength and return to close up my exposed tibia
patch a spot on my
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 over one night and half of the
open areas on my thigh healed! My tibia healed,
to the disappointment of Dr. Morrison, who remarked "that spot there is
just crying out for me to drill some more holes." At one point, holes
were drilled to the marrow in my tibia to create a blood supply for the
tissue to grow over and he was anxious to try it again! Finally, my skin
grew so well and is in such good condition, I did not require further
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
was damaged, so my right arm no longer worked. I began
rehabilitation in late July, was released in mid-August and returned
home. At one point, 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. 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
5k with Denise. I finished
13th overall and won a third place medal in my division (duffers and
geezers). Finally, 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.
I am enjoying my work as a Postmaster once again. I have also resumed
serving as a pastor and am writing a book about the entire experience. I
praise and thank God for His grace and mercy!
Update 2010: Tennis! I never imagined I'd ever play tennis, but thanks to my friend Ryan and a racquet from Donna, I'm back in the game. The backhand and serve are pretty weak, but it's just a joy to be able to get out on the court.
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 intervention is up to you, the reader, to
decide. I remain convinced that it was God's grace, through both
miraculous and "ordinary" means, that saved my life. 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!
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 rosey 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 have lost loved
myself and experienced grief.
may not have been
great or debilitating as what others go through, but that does not diminish
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
those I often 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.