CJ had a great night. Pretty much slept right through. I woke up every few minutes for about an hour until the nurses got one of his monitors reset. After that, I was able to have a good night's sleep as well! We've had a lot of information thrown at us today, so I'll try to be thorough.
It was a day of ups and downs.
Infectious Diseases doc came by in the morning & clarified some stuff. Said the "gram test" from yesterday actually showed that there was a bacterial infection, but that they didn't really know for sure it was staph. But it's consistent with staph, so that's why they were treating him with the vancomycin. The cultures will confirm staph & what form it is. The complication is that since CJ has been on antibiotics, the cultures may not grow at all. When the ID doc was there, he said they hadn't started growing yet. He was keeping his fingers crossed that they would. The only other way to confirm staph is by doing a DNA test on the bacteria. He requested that yesterday, but the lab didn't want do it because the sample came from a wound. He's going to call and talk to them to try to get it done. He did confirm that the infection had not entered the blood stream. This is a HUGE praise!
Because vancomycin is so strong, and because it can cause kidney problems, blood is taken ever 4 doses to monitor levels. His fourth dose was a little before 9:00AM, so they had to stick CJ and pull some blood. He was a little concerned to hear he was having some blood drawn, because of the trouble they'd had getting blood on Monday. But he wasn't dehydrated anymore, so it was quick and painless for him. They got it in one stick. They also started giving him Zantac, because the vancomycin can cause heartburn.
They ordered a "PICC line" for CJ. It's like another kind of IV that's higher on the arm and goes straight into a major vein. PICC stands for "Peripherally Inserted Central Venous Catheter." A PICC line is inserted into a vein in one of the arms and extends all the way through to a location near the heart. This is an area of high blood flow and allows better mixing of the IV medications. With a PICC line, we will be able to continue the vancomycin at home. The vancomycin treatment will last 2-6 weeks, so the PICC line is a big deal. We will give him the injections 3 times a day, & a home health care service will come by once a week to draw blood & change the dressings.
The PICC line is inserted by a radiologist using x-ray. About 30 minutes before we went down to Radiology, one of the radiologists came by and put some numbing cream on CJ's arm. We weren't allowed in the room for the procedure, because it's a sterile environment. They use an ultrasound to guide the wire into the vein, then cut the line to the appropriate length (so each person's line is custom.) Once the line is inserted, they confirm the placement with an x-ray. The whole procedure took about 30 minutes.
Most of the afternoon was pretty uneventful. CJ would napped a lot from the Benadryl. He continued his breathing therapy every two hours. Pain levels were consistently 5-6 .
CJ's temperature was up a little bit later in the afternoon, but everything else was fine. Then, at 5:30, his pain level really started to go up. He was complaining about pain in his upper left chest and didn't want to move his left arm at all. We needed to change his shirt, because 1) he was in the same shirt he wore to the hospital, and 2) it had puss that had drained from his incision. Since he was hurting so much, we decided to wait until they switched the IV drip to the PICC.
By 6:08PM, CJ was really agitated. He felt warmer, so I requested temp taken. His primary complaint was still his upper left chest. He complained of difficulty breathing & asked for oxygen, even though his O2 level was 96% & his heart rate was 118 bpm. When they took his temperature, he had a fever of 102.9! His pain level was up to a 9. He was in so much pain, that he actually told the nurse to cut his new shirt (that he loved) to keep from having to raise his arm. When we got his shirt off, I noticed the left incision site was red & swollen. It wasn't open, but it sure looked like it was infected underneath. I can't put into words how miserable he was...this was not my CJ.
Almost an hour later, he was still hurting a lot. The nurse sent a request to the doctor for additional pain medication, and finally, at 7:30, CJ got some morphine. When they took his temperature again around 8:00, it was back to normal.
Seeing him in the state he was in completely wiped me out. He was so miserable, and there wasn't a thing I could do to help. I actually had to leave the room for a few minutes while the nurses worked with him to weigh him and help him to the bathroom. My biggest concern was the fact that he spiked such a high fever when he'd been on IV antibiotics for 3 days. It just didn't make sense to me. It really had me worried.
I was glad that CJ got some relief and was starting to return to his normal self by the end of the evening. He and I both needed a good night's sleep.
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