Monday, March 16, 2009

Update

The port removal itself actually went well today, despite the fact that we were rushed off to it unexpectedly this morning. All night long, I would ask the nurse if she had heard a time from the OR with no luck. At 5am, the surgeon came in to talk to me, but Keegan stirred and was uncomfortable, needing his g-tube vented. The surgeon's specific wording was "I'll come back in an hour or two" and walked out the door. Silly me, I took this to mean I could close my eyes for a bit longer. Then at 6:45am, the nurse throws the door open and declares that the OR is ready for us now. Geez. At least she let me have five minutes to brush my teeth and change out of the sweats I had been sleeping in.

Keegan did just fine with the anesthesia, but as we expected and feared, they had difficulty getting the IVs. The OR nurse said they started having problems with the lines as soon as they placed them. One was in the crook of his left wrist, and the other is half-way between his right wrist and elbow. Both are extremely positional and finicky. Keegan has been pretty low-key all day, a lot like after his cath/biopsy. We've propped him up on his pillows and let him spend the day watching Elmo and Madagascar. That was working until he hit a little pain episode, threw the IV sleeve on is left wrist completely across the crib, ripped the IV out, and proceeded to wail as he bled all over himself. Down to one IV. So the nurse tried to flush the one on the right, just to reassure us all it was there and working. No such luck. We paged the IV team, and the nurse who came in was able to save the remaining line...for now. Needless to say, Keegan is back on the OR schedule to have a PICC line placed tomorrow.

We really needed two days of IV access to make sure the infection was completely clear. Evidently, when you pull an infected line, some of the latent bacteria can be released back into the bloodstream. As I explained before, the bacteria had formed a film on the plastic of his port. It will attack new plastic in Keegan's body, so we were trying to make sure the bacteria was gone before placing a more permanent line. So, we'll proceed with the PICC tomorrow. A PICC can actually last quite some time in people who understand how to be careful about it being in their arm. Keegan doesn't know not to run around on his lines, roll over in his crib, throw toys around the room, pull on foreign objects coming out of his skin, and/or wave his hands in the air like he just don't care. We would love to be able to keep a PICC for awhile, but after today, I'm just not seeing it. I don't think our admitting GI doc thinks he'll keep the PICC either, since he walked in on the bloodbath this afternoon.

Please pray that the PICC placement goes well tomorrow, and more specifically, that Keegan does well with yet another dose of general anesthesia. We're running the second dose of post-port-removal-big-gun-antibiotics right now, and two was the minimum we needed to feel somewhat satisfied of clearing the infection. Unfortunately, Keegan's temp started climbing as I have typed this, so please also pray that it stops dead in its tracks. We can't get a PICC with a fever. Thank you so much for your prayers today. We are just so grateful for each and every one.