Dr. Kang came by this morning (at 7:45 – I was a bit surprised to see him so early!) . The site is still red, and black spot is visible, and it’s started dripping again. Looks like the expander needs to come out in order for the infection to clear. We tried to save the expander, but (unsurprisingly) it just isn’t happening.
I’m kind of excited to get the expander out (especially because it’s hurt since the beginning of the month, and I’m ready for that to stop) except for one thing. Since there’s an infection in the pocket, Dr. Kang won’t be able to put an implant into the site until the infection clears. That means he’ll be taking the expander out and putting nothing in its place. That makes a pocket where fluid can gather so I need a drain. Blech.
Surgery is scheduled for 6pm tonight. Luckily, Dr. Kang let me have breakfast. No food or drink after 9am. My breakfast arrived at 8:30 – plenty of time to finish before the ban started.
This morning’s breakfast – French toast today.
The other good thing is since I’m already hooked up to an IV, I won’t have to worry about them trying to find a shriveled vein when I go into the OR dehydrated. I did have to get a new IV site yesterday since the old one started infiltrating (which means the fluid was being pumped into the tissue instead of the vein). The timing could have been better, since I was on a Vanco drip at the time. If it had just been the maintenance saline, I could have stayed off the IV until close to 9pm. As it was, I had a half hour or so free of my dancing partner. I took advantage of it and did a couple of trips around the hall.
My new IV site
It was very uncomfortable yesterday and I had a hard time finding a position the arm didn’t ache, but this morning it’s much better. Sleeping with it must have readjusted something since I can use the arm without it hurting today.
When I first was admitted to the hospital, I was furious that I would have to spend days in the hospital. Who wants to spend days in the hospital? Stupid expander. Stupid infection. Can’t it all just be over. Now I’m at the point where I’m feel I’m never going to get out of the hospital. I’m not bored – just tired of being hooked up to an IV tree and stuck inside.
The lovely view out my window
Today’s doctor’s visits didn’t go as well as yesterday’s visits. The Infectious Agents (IA) doctor wants the expander out (which is what Dr. Kang said they would say). Dr. Kang wasn’t quite as positive for today’s visit. While the redness seems to have declined (although the IA disagreed with that assessment), there’s a black spot within the oozy spot. Most likely, that blackness is the expander showing through. If we can see the expander, the sore will not heal over it and we’ll just need to take the expander out. It could be OK, but the spot will need to be gone tomorrow morning. Otherwise, it’s time to plan surgery.
Surgery will entail taking out the expander, cleaning out the area, and letting it heal with nothing in the space. I would actually be happy if we got the expander out. The big negative would be since we wouldn’t put anything in that space, I would need a drain. I HATE drains with a burning passion. Drains ruin my life. Once everything heals, Dr. Kang would go back and put in the implant. I’m torn – getting the expander out is a major bonus, but having a drain is one of the worst things.
Best case scenario, I could have surgery tomorrow night and be home within 24 hours. It depends on the availability of the OR. Tomorrow morning I’ll know more. It’s all so up in the air and dependent on how things are looking. We’ll see how it looks in the morning.
It seems that the antibiotics are working. I saw Dr. Kang yesterday and he thought the redness had decreased since the day before. When I woke up this morning, I thought it had improved even more. The oozy spot seems to be smaller as well, and not as oozy. (I’ll save you the pictures.) Dr. Kang said if the infection continues to respond to the IV antibiotics, they’ll put me on oral antibiotics on Monday. If those work, I could leave on Tuesday, and still have the exchange surgery on the 10th. Good news to my ears. If the antibiotics aren’t working well enough, the expander needs to come out while I’m in the hospital, and the implant will be put in at a later date.
I saw the Infectious Diseases doctor yesterday as well. She wasn’t very helpful. She talked a lot, but I realized when she left, she didn’t say much of anything. The one bit of information she passed on what that it didn’t seem likely the blood cultures would come back positive for anything. I wasn’t showing any signs of infection (like a fever) beyond the localized site. (My nurse this morning said the 24 hour preliminary blood cultures came back negative.) Since they wouldn’t have any detailed information, they’d just keep me on the Vancomycin.
I slept better last night, once I was able to go to sleep. I’m sure it helped I didn’t have the nasty squeeze-your-leg wraps on. They’re used to make sure you don’t get blood clots because you’re not up and around. Thing is, I’m up and around, so I don’t need my legs squeezed regularly. The only thing worse than the squeeze-your-leg wraps is the fact the nurses need to monitor my kidney function. So, every time I pee, I’m supposed to pee into a “hat” in my toilet and then call the nurse to empty it.
The hat in my toilet – so lovely
I did have a lovely breakfast this morning.
Breakfast – I’ve learned to order lots of things so I get a full meal.
I’ve got leftover Thai for lunch, and Firefly on TV for the day. Should keep me occupied for a while as I wait for my antibiotics every eight hours, and another visit from Dr. Kang.