Saturday, March 17, 2012

Waiting for more surgery

Emily is inpatient again. She had the UTI last week, and the antibiotic they had called in was not the right one. By the time the sensitivities came back, she had landed herself in the ER again. She had a fever of 101.2 and was trembling and lethargic. Her urine is still positive, so the antibiotic was changed. This time her blood cultures were positive as well.

Here's the thing. We go to "First Class Big Huge" University Medical Center. Last admit, they transferred Emily to the sister hospital of this one, in the next city over. Same University affiliation but NOT the same level of care. It was awful. Her central line had been placed on Feb. 28th, and by March 3rd it was out of place. I had been telling them that the line was sliding in and out of her skin again, this is what caused the line to come out on Feb. 27th. So I wanted a different type of line, or a different type of securement. This is the fourth time a Broviac has slipped out of her chest without being pulled. Obviously, her body doesn't like this type of line and the internal cuff does not develop scar tissue to hold it in place. The surgeon at the sister hospital said he would be placing a Hickman when he took her to the OR. He specifically reminded me that her current (4 or 5 day old!) line couldn't be fixed because it had slid out of the skin some. They never, ever, ever re-instert a central line that has come out of the body. It is almost guaranteed to become infected. Imagine my surprise when she came out of surgery with not only NOT a Hickman, but the surgeon told me that he had re-inserted the line she had in. My jaw dropped.

Prior to her going to the OR, I had asked the surgeon about a port in place of a broviac. I was told no. He said that "First Class Big Huge" University Medical Center does not place ports on kids. Never. Not ever. I said I didn't believe this was true, that I knew kids at our regular hospital (not this little sister hospital) that had ports. He said they must have been placed elsewhere. Oh. *shaking my head in disbelief*

This leaves us where we are now. Inpatient at our regular hospital, because I refused transfer back to the sister hospital. We will never go there again. Her central line is infected, and has to be pulled. They are now saying "It may have been caused by the surgeon's actions, but we have no way of knowing that". Keep in mind that even after the surgeon re-inserted her line, it still continued to slip in and out with each dressing change.

I am so irritated. Had the surgeon done the right thing by either putting a new Broviac/Hickman in, or placing a port, we would probably not be inpatient right now. Yes, she has a UTI, but we could have continued to treat that at home. The bug growing in her blood is not the same as the bug growing in her urine, so it did not translocate internally. This is a different infection. So frustrating!

In better news, she is not too miserable. She is sleeping a lot, almost all day. She is not running a fever anymore, and the trembling has stopped. She is getting two different IV antibiotics for the next 14 days, so we are inpatient for a while. After that time, we will most likely be placing a port. Please continue to keep Emily in your thoughts and prayers. No surgery is easy on her, and her other issues continue to get worse. Her sleep study showed a lot of central apnea. Her neurological status is worsening. Her general instability is huge. This (undiagnosed specifically) mitochondrial disorder is kicking her butt. She still continues to smile at us, through it all!

6 comments:

Lindsay Marie said...

Thank you for the update! I will continue to pray for Emily and all of you!

Alison said...

How frustrating. Am praying this will be a short admission.

Reagan Leigh said...

I'm so sorry that Emily is going through so much lately! I feel as though mitochondrial disorder is kicking our butts too right now! I wish I knew something that could help! Thinking of you guys...

Junior said...

oh how very frustrating. lots of hugs and prayers.

SECRET PEPPER PERSON: said...

I hate it when you encounter a know it all like this doc. I went through this with The Boy with a nasty surgeon who wanted to place a Broviak in his GROIN (a diapered baby!) and refused a port because he had a trache and she didn't want him "spitting secretions all over it." A port? A completely closed system? But she thought a Broviak being sh*t all over was fine? She was later arrested for drunk and disorderly with property damage (her mug shot is still on the internet) and eventually... as I'm sure that was not enough... sued for 250,000,lost so she disappeared. My pediatrician sent us back to her partner after the Broviak incident and he put the port in. We have enough stress without situations like this. I am so sorry you had to go through this.

Jamie said...

Sending Prayers from CT. I want to cry...its just not fair. I dont know how you do it. I dont know how we all do it with our special little girls...but we do! I am unfamiliar with tubes and such but my madie still cannot eat solid foods without gagging and crying..strictly bottle and she is 5..:( hang in there. and pocket those prayers!!