Well, we had a good night, and both of us slept well. (I apparently slept too well, as CJ had to wake me up to tell me to stop snoring! LOL! In my defense, my sinuses are bugging me a little bit.)
At about 3:00AM, it was time for blood to be drawn for the lab, since it was the fourth dose of vancomycin again. At 5:30, CJ got up to use the bathroom said he felt like there was a pinching/tugging at the left incision site, like clothes that got caught on the skin. It wasn't really painful (pain level was about a 6), just uncomfortable. His chief complaint was still the upper chest.
At 6: 45, Surgery made its rounds. We told the doctor about the pain CJ had been experiencing on the left side and the red, swollen area around the incision site. When he felt it, said he could feel puss under the skin. He said as long as there is puss, there will be fevers, even on antibiotics, which answered my concerns from last night. He was going to talk to our surgeon that did the procedure about what he wanted to do. They may use warm compresses to pull puss to surface or may make a small incision to help it along.
A little later, the Infectious Diseases doctor came by and gave us some good news: the cultures were growing, and they knew for sure the infection was staph aureus. This is the most common species of staph and what they had been expecting to see. They still didn't know the strain of the staph, whether it was MSSA or MRSA, but as soon as the cultures were big enough, they will run those tests. I got the impression it would be Friday morning before we found that out. (For more information on staph aureus, click here)
Mid-morning, his pain level went up to an 8, but he was still fever free. He had another dose of vancomycin at 9:00, and his attitude & morale was much better than last night.
Around noon, the nurse came in and said we were changing from vancomycin to two different antibiotics. This surprised me, because neither of the doctors that morning had mentioned changing anything. Instead of vancomycin, CJ would be on Ancef (more info here) and Rifampin (more info here). Since this was an unexpected change, I had the nurse page the ID doctor who ordered the change and ask to come explain it to me. CJ was feeling a little nauseous, so he also asked for some anti-nausea meds. When they checked his temperature, it was up a little to 100.8.
Thirty minutes later, the ID doc came by said cultures showed MSSA!!! (As a reminder, that means the staph is NOT the resistant strain and is more easily treated!) That was the reason he changed antibiotics. He said he was hoping to get in to tell us before the new orders went through, but obviously, that didn't happen. We were so thrilled about this news, it was hard to wait until the doctor left to proclaim it to the world! We've had so many people praying for us, that we knew they would be rejoicing with us.
Over the next couple of hours, CJ had a rough time with pain. He had very shallow breathing and sounded winded when he spoke. He also started getting agitated again like last night. The nurse took his temperature, and it was 100.5. His pain level even got back up to 9. It's so strange to see the change in CJ when his pain & fever start going up. It's like Dr. Jekyll & Mr. Hyde.
Around 3:00, CJ was feeling much better and decided he wanted to go visit another patient we met our second night here. This young man is 2 years older than CJ and had the Nuss Procedure earlier this week. They clicked pretty quickly, and enjoyed sharing "war stories" of pain, recovery, and missing the "cereal bowls" in their chests! We had a great time visiting and ended up spending a full hour in their room! Both boys started getting tired at the same time, so we said goodbye and headed back to our room.
Just as we got to the elevator, the surgeon called my cell phone. He was looking for us, because he wanted to do an "I & D" procedure on CJ. "I & D" stands for "Incision & Drainage," and it meant they wanted to cut into the wound and drain the puss. It's a simple procedure, and the doctor could do it bedside. Instead of making an actual cut, he was going to stick a syringe into the area under wound and suck out the puss. Obviously, CJ was very concerned about it hurting, but the doctor assured him he wouldn't feel it. He first gave a shot of lidocaine around the area; anyone who's had to have lidocaine shots before dental work, will know how pleasant this experience is. However, once the lidocaine took effect, everything was fine. The doctor pulled out 3CCs of puss and sent it off to the lab for testing. Our hope is that removing this puss will keep CJ from spiking a fever again. If he doesn't spike a fever again, there's a possibility we could go home tomorrow. If he does spike a fever, they may decide to put a drain in to help the infection drain out.
After the I&D, CJ's pain level was 7. He just wanted to rest for a bit, so his dad & I went to have some dinner. When he woke up, our old CJ was back. He was pleasant, joking, and fever-free. We were having such a good time that he actually ended up having to call for some pain medicine because he'd been laughing so hard! (Coughing, laughing, hiccups, & sneezes still hurt.) He actually commented on how much better he was feeling.
A little after 9:00, CJ noticed the right incision sight oozing. It had soaked through the gauze, so he requested a nurse to clean & rebandage it. The nurse applied antibiotic ointment and a fresh bandage, but said we should wait until the surgeon came by in the morning to see what he wanted to do about getting the puss cleaned out.
At 10:15, CJ said he was feeling a little nauseous again, so we requested some Zofran. Less than 30 minutes later, he vomited all over himself. It happened so fast, he didn't even have time to tell me he was about to be sick. Needless to say, we spent the next 10 minutes getting all of CJ's bandages, sheets, & clothes changed.
Once he got back into bed, CJ felt much better. He went to sleep shortly after that and is so far sleeping well. Our prayer is that we both have a good night again and that his pain & nausea are managed well.
As I mentioned, there is a chance we could go home tomorrow, and because of that, the hospital has already scheduled a home health service to come to our house & teach us how to use the PICC. If we end up not going home, they will reschedule the service. The "complication" is that the home health services rarely get new patients set up on weekends, so if we don't go home tomorrow, we're pretty much guaranteed a stay until at least Monday.
I'm heading to bed now and praying for another decent night's sleep.
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