Monday, April 27, 2009

More Delays

We might be mistaken as ranch hands near Soledad taking care of soft rabbits because once again, like mice and men, our best laid plans have gone awry. We had planned on returning home today, but it wasn't meant to be. There was a good reason for the change at least. It turns out that the doctor's primary theory of what caused the infection wasn't right.

The runner-up theory was the winner: the Groshong line that has been in since September became infected, causing the fever. The doctors had a hard time identifying the cause because of a large number of white blood cells they found in the urine when she first checked in. They followed the train of thought that there was a urinary tract infection, but it didn't make sense that the urine white blood count dropped in the following days. They continued to find bacteria in the blood samples, however. Once they realized that the elevated reading was probably due to the urethra "thing" that was irritated by the urological exam, they were able to narrow down the cause to the line. Ports and lines are notorious for getting infected, and they never like to leave them in longer than is necessary. Krista's was still in for convenience. She is still getting weekly IVIG transfusions and will continue to get them until 100 days after the stem-cell transplant. That day is May 8.

There were now only two things they needed to do before they let Krista go home. The first was to get the port out. That's pretty much the only way to deal with an infected port. Monday is usually booked for vascular surgery, but somehow they arranged to get Dr. Julie O'Connell (sp?) to Krista's room for a late-afternoon procedure. Krista was very nervous about the procedure because the Portacath she had from the first round of leukemia was not only excruciating to get out, but she had ongoing pain for months after it came out. Fortunately, that was not the case with this line. The doctor gave her lots of local anesthesia, and though she had to work it quite a bit, the line came out without much pain at all.

The second thing that the need to do is get us a prescription for antibiotics to take home with us. In order to do that they have to know the specific kind of bacteria it is that infected the port. So far they are only able to identify it as "generalized staph", but they need to find out if it is the kind that can be treated with oral antibiotics or if it's the tougher variety that needs IV antibiotics. The oral antibiotics are easy, but the IV ones are more complicated. I can administer the IV antibiotics at home, but she needs to have a PICC line put in first. The lab results won't be back until the morning, so they won't be able to schedule the PICC line until tomorrow if they need it. Putting it in is not a long procedure, but it may take some time to get a doctor. So though, we should be able to come home tomorrow, we're not sure when that will be.

The LORD your God is with you,
He is mighty to save.
He will take great delight in you,
He will quiet you with his love,
He will rejoice over you with singing.
"The sorrows for the appointed feasts
I will remove from you;
they are a burden and a reproach to you.
At that time I will deal
with all who oppressed you;
I will rescue the lame
and gather those who have been scattered.
I will give them praise and honor
in every land where they were put to shame.
At that time I will gather you;
at that time I will bring you home.
I will give you honor and praise
among all the peoples of the earth
when I restore your fortunes
before your very eyes,"
says the LORD.
(Zephaniah 3:17-20)

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