Thursday, December 27, 2012

Line #6 is in

Keegan is the owner of a shiny, new central IV line.  This is his sixth one in five years (excluding PICCs and other more temporary central access during ICU stays).  Three have now been lost to infections, one was removed for non-use (thinking he was doing well and didn't need it, just to need one again a few months later), and the infamous port that was in his subclavian artery.  You know that little one that had the potential to turn him into a vegetable....yeah, let's not talk about that one.

The surgery went well overall.  They put another broviac line in, instead of a port.  If I am confusing you with talks about lines, you can find a good summary of different central venous catheters by Stanford School of Medicine by clicking HERE.  He didn't end up going to the OR until about noon, and we were back in his room by 3pm.  We woke him up around 3:45pm because we were afraid he wouldn't go to sleep tonight if he slept much longer.  He was in an ok mood but didn't want to leave his bed.  He ate a little bit of dinner and fell fast asleep tonight.  Now that he has central access again, he can get his TPN tonight.  Hopefully that will "top off his tank" and help him feel even better tomorrow.

We are expecting that Keegan will be discharged tomorrow to continue the course of IV antibiotics there.  The hospital is swarming with flu and an epidemic of other viruses, so we need to get out of here fast.  We are also consulting with the infectious disease doctors and an oncologist who specializes in line infections in severely immune-compromised patients to see what additional steps we can take to prevent these opportunistic infections.  We will probably try something called ethanol locks, where we push a small solution of ethanol alcohol into the line, let it sit there for a few hours, and then draw it out.  It's kind of like a disinfectant for the inside of the catheter.  Other than that, we have been assured we are doing everything else right.  This pseudomonas probably translocated from his bowel into his bloodstream and his line, a rare and unpreventable complication of immune suppression.  On a side note, one of the nurses today told Gray that she saw the picture of the culture that had grown out pseudomonas and that it was the most raging, nasty one she had ever seen.  If we hadn't been on high fever alert from the strep and pulled that line immediately....gosh, I don't even want to think about it.  As bad as Friday night was, it doesn't surprise me though.

Time to wrap this up.  I'm watching the Baylor bowl game on Gray's iPad while Keegan is sleeping, and halftime's almost over!  Sic'em Bears!!

Here's a few good photos for you.  Keegan was in the BEST mood waiting in the pre-op area this morning.  I mean, seriously, I haven't seen him like this in a long, long time.  He wanted to take a picture with my phone, and here's what we ended up with.  Enjoy!







1 comment:

Paula Pruett said...

Love these smiles - know they were a blessing in this middle of your latest storm. Know that we are still praying for all of you!