Infectious Isaac

Infectious describes Isaac in many ways, which, when he laughs, it is genuinely infectious! And then you have his lower incision today, which has a very deep infection. Let me bring you up to speed.

Thurs (2/14) - see previous post - spent some time in the ER - went home to sleep.

Friday (2/15)
On Friday, we got to CMH at about 1pm for an expected surgery time of 4pm. Eli went to spend the night with Grandma and Grandpa, and Gigi came up to the hospital to be with Isaac and mommy and daddy. (Pops is in San Francisco, where we heard he was having a lovely time, walking on the pier, hearing live music on the street, enjoying the warm weather... but I digress). :)

Isaac was quite visibly uncomfortable. By Thursday (2/14) night the incision had leaked some, which is what had prompted us to go to the ER. By the time we had arrived for surgery, the incision was puffed up about 2-3cm, and was nothing like I had ever seen before. (I know, I keep saying that, but each day has brought something else). We were just really anxious to get him into surgery, because we knew that was all that was going to make him better. After all of the pre-surgery business, he got some Versed, and once that took effect, he was whisked away into surgery.

We were prepared for everything from a very superficial infection that would basically just need to be cleaned out and sutured back up, to depending on how much infection, the possibility of needing to remove the rods and clamps we'd just had placed a month ago. As time went by when he was in surgery, I think we each got a feeling that this was more than just a superficial infection. Isaac ended up being in surgery for a little over an hour. The infection was indeed deeper than we'd hoped, and had opened up the superficial fascia, which had been sutured up very tightly after the surgery last month. So, Dr. S had to reopen the lower incision, which goes lengthwise from about the middle of his back to just just below the diaper line. Isaac did not have to have the rods and clamps removed, but just about everything short of that. He cleaned out the incision, all the way down to the rods, and instead of suturing him back up, he put a dressing on the wound, called a Wound V.A.C. (or negative pressure wound therapy) to assist with healing. There are many positives to using the Wound V.A.C., but one of the drawbacks is that it is very hard to manage at home. Couple that with the fact that the infection was deep enough that Dr. S anticipates taking Isaac back into the O.R. on Monday, and then again on Wednesday to clean the wound out again each time, and reapply the Wound V.A.C dressing.  This unfortunately means that we are here at CMH for at least a week.

Isaac did have a lot of anxiety once we got settled in his room, and was having difficulties with his breathing. He was retracting and breathing very shallow. He had an x-ray of his chest and abdomen, as he was (and still is) quite distended. It showed some mild atelectasis (small areas of his lungs that are inflating as much as they should), as well as lots of air in his abdomen, but no bowel obstructions, or fluid, or anything else of concern. The nurse put him on some oxygen, and we gave him some pain meds. He eventually settled down, and got a good nights sleep. He ended up doing quite well breathing, and came off of the oxygen during the night.

Saturday (2/16/13):
Isaac has been resting fairly comfortably for most of the day today. It takes a lot of rest for your body to heal, so he slept most of the day, off and on, and then has been very alert from about 4:30 on.  One of the biggest concerns we have right now (7:45pm) for Isaac is that his abdomen is incredibly distended and his stomach area is so huge right now a diaper barely is fitting on our little guy.  We are awaiting Dr. B to come and give a recommendation as to what to do for him.  Our guess is it will involve unfortunately an enema.  But (no pun intended) whatever is best for him is what we will do.

His culture from the wound infection came back positive for staphylococcus aureus (common staff infection - NOT MRSA).  This is a serious infection that will have to be treated with multiple antibiotics for several months.  The biggest concern is that we don't want the infection to contaminate the rods.  That is the reason we will have to do the antibiotics for so long.

Our little guy right now is in some pain, and that makes it hard for us.  But, we obviously hope he will be able to kind of turn the corner here and feel better throughout Sunday.  This healing will then be derailed again Monday when he will have to go back to the operating room again.  This is truly going to be a week of ups and downs.  We will give another update tomorrow as we prepare for surgery #2 of this stay on Monday.

And - Eli did get to spend the day with Grandma and Grandpa. He got to make a trip over to the beautiful metropolis of Manhattan, KS to help celebrate his Aunt Andrea's birthday, and to see his cousins, Tyler, Ian & Patrick. Oh, and of course, Uncle Rusty too! He was SO excited to get to go! He's camping out over at Grandma and Grandpas. They love having him (and Isaac when he's well), and the boys love spending time there too. 

Thanks again for all the support and love you all show us.  We couldn't be doing this without all of you.