Flesh-eating bacteria claims arm, but not will to live

The Feb. 25 fall off the curb onto her right elbow felt awkward but certainly not life-threatening, thought longtime nurse Rhonda Muhlenbruch of Iowa City.

Not until Feb. 26, when the pain became excruciating, when she felt extreme nausea and began vomiting, when her veins closed. Then Feb. 27, when her blood pressure fell to 50 over 30, when her heart beat 200 times per minute, when her organs shut down, when her skin became jaundiced, when black blisters covered her elbow, when doctors huddled in the emergency room to determine the cause.

Necrotizing fasciitis, they theorized. Flesh-eating bacteria.

“I've never been this sick,” Muhlenbruch, 49, told her only daughter, Abbey, as the family was called to the intensive care unit at Mercy Iowa City. “I'm going to die, but don't cry.”

By 7 p.m. that night, Muhlenbruch had been transferred to University of Iowa Hospitals and Clinics. By 8 p.m., her right arm had been amputated above the elbow.

That was the first of five surgeries. More of her arm was cut off. Part of her side. Part of her breast. The bacteria's rapid growth had to be stopped, or she would die.

lll

In 1989, about nine months after being hospitalized for nine weeks to give birth to twins, Abbey and Benjamin, Muhlenbruch suffered chronic sinus problems. Several surgeries later, a horrible headache sent her to the emergency room. Within two hours, she was in a coma. She underwent a spinal tap.

Bacterial meningitis.

“I nearly died at that time,” she says. “I had a white light episode then. I saw my mom, who told me to turn around and go take care of my babies.”

Her mother had been gone seven years. Muhlenbruch would be in and out of the hospital for eight weeks.

lll

Walking up her Iowa City condominium stairs, Muhlenbruch steadies herself by pressing her left palm against the wall. The right railing does no good, because she has no right hand or arm.

“One of the most frustrating things is trying to spread peanut butter on a piece of bread,” she says.

On Thursday morning, her house will not be filled with the aroma of bacon and onions as she prepares stuffing.

“I can't make Thanksgiving dinner,” she says through tears. “Some of that is just taking hold.”

For Muhlenbruch, grieving mixes with anger as she fights with her insurance company for a motorized prosthetic arm.

With medical costs approaching $1 million, she had nothing but praise for her insurer. That is, until the company determined she needs only a simple prosthesis, one that won't bend at the elbow, instead of a $116,000 electronic arm with moving fingers.

“What are these prosthesis for, if not for people like me?” Muhlenbruch says. “In order to be the best person I can, the most productive I can be, I need this prosthesis. I'll be back on the tax rolls. I won't be a burden to the government.”

She and husband, Terry, have written to government officials, including President Obama.

lll

When Muhlenbruch fell, she protected grandson Brayden, 11 months, by holding his head in her hand.

“One of the hardest things,” she says today, “is I can't pick up the grandbabies. I can't baby-sit them by myself, because somebody has to put them in my lap.”