Wednesday, August 09, 2006

Just shoot me now

Okay ... get a sense of how I'm feeling today? (I clearly have too much time on my hands, eh?)

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Update: Apparently the decision has been made by ortho that Jack is getting a broviac because they have already called the general surgery team and an OR time has been scheduled. Gee, nice of them to get my "OK" on this. And, the general surgeons want pre-op blood work. WHAT???? I have no doubt that the peds team docs -- who are only the "messengers" for the most part -- are drawing straws to see who has to come to Jack's room and deliver the latest news. I found out that a CT surgeon (cardiothoracic for you non-medical people :-) can also do a broviac - and the same CT surgeon who operated on Jack last summer is available and willing to place the broviac (they tell me he "loves" to put in broviacs). I told the pediatric resident that I want CT to put in the broviac, not the general surgeons. I was told that ortho called the general surgeons, to which I said ... it's my decision and I want the CT surgeons. Ortho is gone for the day and they will "talk" with me in the morning. I am beyond rational right now, but I am adamant that CT put in the broviac -- they know Jack and I like them better! Tomorrow morning should be interesting.
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Here's where we are today. Jack's first culture has been determined to be contaminated, his culture from yesterday is negative and his "bands" (indicating a bacterial infection) are down from 21% to 1%. All good things, you say. But, Jack is still running that nasty little fever. The ID team came up with a plan -- do additional cultures and if they are all negative, take Jack off the antibiotic and see how he does. Sounded like something I could (almost) live with. However, the orthopedic team (who has been incognito for days and didn't have much to say about the fever that they've known about from the get go) come up today -- en masse and making quite the entrance -- and decide that we have to be "aggressive" with this and proceed to tell me that Jack needs to get a broviac and start IV antibiotics asap. They've damn near got the OR team scrubbed and ready to go. It's really difficult to make a decision when you can't even get everyone on the same page and, especially when the people telling you to put in a broviac are surgeons and surgery to them is ... well ... no big deal! I've asked to talk with the ID team tonight before they leave and get their opinion. I seriously am losing my mind now (and deep breathing is not helping). I know we really have no choice but to agree to the broviac because the orthopedic surgeon flat out said if we aren't aggressive, "he might not survive". Surgeons ... always known for their compassion and tact.

I have NO idea what to do at this point. Someone out there want to make the decision for me? Please. If we don't get out of here by the weekend, I may very well spend a fortune and fly home for the weekend. Mark is flying out tomorrow night, as we were supposed to be on the road for home by Friday. Mark can stay with Jack over the weekend. (Fitzgibbons gang -- I'll call and let you know what is going on as far as whether I'll be at work on Monday).

That's the latest and the greatest for now.

19 comments:

Barb said...

oh, Ann. This sucks. If it weren't surgery, I'd be all in favor of the broviac b/c then there won't be any more sticks for blood draws, would there? If he's in this for a while, that alone might be worth it. Talk to ID before you do anything, though.
Why didn't they just do a port or something in the first place??

Melisande said...

Amen, Barb. You'd have thought they'd have thought ahead about this possibility. Well, Ann, hindesight is 20/20. Isn't that comforting? You've got a plan and the right people to talk to. If they're all in agreement, then I think the decision is made for you. Sounds like they didn't want to send just one surgeon to you to "discuss" the issue, so they must mean business! Just a weird way to do it, if you asked me. Hope you know something soon. {{{HUGS}}}
Melisande

Anonymous said...

Ann,

I can't add much more than Barb and Melisande. But that sure must have been overwhelming to have the whole surgical team bombard you.

I know you will make the best decision for Jack. Hopefully this will be resolved soon...

Big hugs,
Jennie

Anonymous said...

Hi Ann,

The Internet has been down today. It was up just briefly this morning and late yesterday. I'm so sorry for all that Jack is having to go through and you must also feel so overwhelmed. I'll keep praying for you guys.

Martha.-

Anonymous said...

Ann,
This is my favorite prayer, hope is helps;
The Serenity Prayer
God grant me the Serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.
Praying for you,
Alma

Marcie said...

Ann,

I just want to give you a big hug. Making all these decisions is difficult enough when you have all your family around. It's just not fair that Jack's dealing with all these complications and you have to deal with the doctors by yourself. Please take care and know that you are in my prayers!!

Marcie

michelle said...

We're praying for you all every day. In such a difficult situation, Jack is blessed to have you, Ann. We're thinking of you often.

Michelle and Sara

Anonymous said...

Yikes! Tell Jack to cut all this fever crap out and just get better! NOW!
I hope the next few days go better than the last...still praying for you and Jack!
Karen

Gloria said...

I just am crying with you Ann and can sense your wanting to punch the nearest person!! but you have to remain reasonable for Jack!!! I've been praying constantly for you and Jack since I was able to read your latest (internet still down most of the day at work!--Anita is livid!). I wish they had put in this broviac when they did the surgery. (I had to look up exactly what it was, although I had a feeling I knew.) You have my permission to get angry and be a bitch! and I wish I could come and take over for a while. I hope that Mark being there will help with moral support and at least give you some relief. I think if you're able to leave for a while (or longer than a while), it will help your prespective a lot. Please let God take over for you when you are at your wits end. I know from personal experience that He will! Prayers are coming and I'm sending out the SOS to my prayer people!! I'm trying to help Martha wherever I can, so don't worry about FLO. (I'm sure the guys would say the same thing, if they haven't already...) When all this is over and you and Jack are safely home, we can deliver a case of beer for you to enjoy! Keep the faith! Gloria

sebby said...

ann-

orthopods are lugheads and infectious disease docs are, in general, very smart. just generalizing, but seriously, do not feel obligated to do the broviac at all if you have doubts, esp if the team that specializes in infection is not convinced he has an infection! OR schedules are pretty much made to be cancelled!!
on the other hand, if YOU decide to go ahead with the broviac, you clearly have your choice of surgeons.

go fight them tiger!!

sebby

Julie worthy said...

Ann

Hang in there and stand your ground and get the surgeon you want. I am so sorry that you are having to suffer this, but hope that you can get a break and fly home for the weekend. You need to get some rest yourself for Jack's sake, and for your own sanity!

((((HUGS))))
Julie

Anonymous said...

Well. Now I know what I did in my past life to get here...

Ugh. You warned me you had a feeling, didn't you? Poor baby, and that goes for both of you.

Whisper in Jack's ear: if he battles off the infection, you promise to tape pop caps to the wheels of the surgeons' desk chairs!

As always, y'all are in my thoughts.

Kar

Melisande said...

Ann,

Get the surgeon you're most comfortable with. It's the least they can do given the situation. We'll be right there with you!

Love,
Melisande

Kathy Hawley said...

Ann,
What can I say? This whole deal sucks for all of you. Go for the surgeon you are comfortable with. Hopefully, the broviac will also solve the blood drawing trauma for him.
With love and prayers,
Kathy

Anonymous said...

Ann, I hate it when they bombard you. Why do they do that?!! Ugh. If there is a remote chance Jack will need IV AB's, I would do the broviac. It really is a lifesaver. Either way, do it on the terms YOU are comfortable with. Lots of hugs, Whitney

mom2twinsplus1--Lori said...

Prayers still for you. I hope things go smoothly from here. Its sad to hear he needs to get the broviac but the good thing is No more poking! I will keep praying for Jack

Erica said...

Hi Ann,
I know how much you hate feeling out of control, and these guys aren't helping much. I can't see why they would care one way or another who does the surgery, so hopefully getting CT to do it will be a non-issue.
Also, I have to agree with Sebby's comment of orthopods vs. ID docs. Infectious disease docs, ARE, after all, internal medicine docs first, and you know how smart we are. ;-)
I know the prospect of another surgery, however "minor" (no such thing, as you know), sucks, but I think getting a line in Jack is going to be best for him in the long run, now and in the future. I hope everything goes smoothly and SOON!
Call me if you need to vent!
Love,
E

Anonymous said...

Ann,

I hope things went better today. Just know we are thinking of you...and praying...

Jennie

Anonymous said...

Oh Ann,

I sure was hoping to see that Jack was out of the hospital when I logged on tonight. I'm sorry this has been so difficult for all of you and painful for Jack. Lots of prayers and I would definately push for the surgeons that you trust!

Love, Sandra