For short

From an appointment on October 2nd with an orthopedist, the clipping nec fac /nɛk fæk/ for necrotizing fasciitis (from the doctor). This was a new abbreviation of the disease name for me; I was accustomed to the initialism NF /ɛn ɛf/ (from other doctors). And I wondered about the /fæk/ piece of the clipping, where I would have expected /fæʃ/ or /fæs/, given the full pronunciation of fasciitis, with one or the other of these  as the first syllable.

It looks like the /k/ comes from the spelling, with C, rather than the pronunciation, thereby echoing the /k/ from necrotizing, which is also spelled with C. The clipping then preserves elements of the spelling, in a way that the phonologically more accurate FASH or FASS (neither attested) would not. A complex interaction between pronunciation and spelling.

Nec fac is well attested. Three examples from many:

Necrotizing fasciitis doesn’t really eat your skin away, at least that’s an inaccurate description. Nec Fac, as we medics contract it, happens when infectious bacteria end up in a layer surrounding your muscle called fascia (link)

I had Nec Fac, in 2003. I was a long recovery. But remember you have your life. Stay strong!! (link)

Have you read “Complications” by Gawande? He’s got a gripping story about a young girl with suspected nec fac. Big part of it was making the decision of if he should or should not operate…seems that is one of the main hurdles in the initial phases before limbs start falling off and everyone goes, “oh shit, that is nec fac”. (link)

Note on necrotizing fasciitis, with the initialism NF, from Wikipedia:

Necrotizing fasciitis … or NF, commonly known as flesh-eating disease or flesh-eating bacteria syndrome, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue.

(NF, which can involve any of a great many strains of bacteria gone rogue, is a truly nasty disease. I recommend against looking at the web resources on the disease unless you have a strong stomach.)

At the same appointment with the orthopedist, the bacteria responsible for my NF infection in 2003 — methycillin-resistant Staphlococcus aureus — came up, under the name MRSA, an alphabetic abbreviation treated here as an acronym, that is, pronounced as an unanalyzable word /mǝrsǝ/ (like “mursa”), rather than as a sequence of letter names /ɛm ar ɛs e/.

So three different sorts of abbreviations — clippings, initialisms, and acronyms — came up on the occasion. A nice illustrative package for the linguist.

But why, you ask, did NF come up at all in the orthopedist’s appointment? (If you’re not especially interested in the details of my life, you should bail out here.) Because if there’s an infection in the fluid in my hip joint, a joint replacement would be a medical disaster, and my previous major staph infection was a danger sign. So the orthopedist required a needle aspiration of some fluid, followed by a culturing of any bacteria in it, to ensure that the bacterial coast was clear. Scheduling the aspiration, however, has turned out to be a drawn-out headache. Posted to Facebook yesterday:

Vexing day. Had 11:30 appt. for a needle aspiration in Physical Medicine at PAMF, got call from the dept. at 9:15 saying that the ultrasound machine they were going to use to guide the insertion of the needle was on the fritz, so today’s appt. was cancelled and the staff said an M.D. was trying to get a place for me, hopefully tomorrow, at another medical center (Menlo Park Surgical Center). Didn’t cry or scream, but I gnashed my teeth and despaired at the weeks that have gone by so far in getting me up to hip replacement surgery.

Ned Deily was then on the train from SF, coming down to drive me to my appt. (and do some necessary things at my library condo). So he did the library condo trip and ran a bunch of other useful errands for me. Good Ned.

Still no medical alternative set. At every step, the docs say they plan to have it … done “tomorrow”, but that turns out to be a week down the line.

This is step 3, and I waver between discouragement and anger. (As do the family and friends who are helping me get through the days.)

[10:30 a.m. update: both the doctor and his assistant are unavailable today. They’ll be back tomorrow. Which is Friday, so we’re looking (once again) at some time next week. Grrr.]


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