Tuesday, November 8, 2011

An update on the last few weeks...

As most of you know, Owen had his right VEPTR placed on October 4, 2011. It was a big and tough surgery and Dr. Campbell placed one long rib to spine rod with two fairly large outriggers that would keep Owen's right ribs from "parasoling" or shutting like a shutter. We remained in the hospital for one week and were thrilled to get home. We love CHOP, and we have some amazing PICU nurses there, however, we were anxious to get home.

We were sent home knowing that Dr. Campbell had a hard time closing Owen this time. The lumps in his back were quite noticeable and Dr. C said that he only got about a quarter inch of skin flap. A lot more skin flap is usually achieved and usually hoped for. But he was able to get it closed.

Nick and I had to make sure we changed the dressing this time, as opposed to June when we were allowed to remove it when we got home. We changed his dressing every 48 hours. The first week home was fine. We had a wound care checkup on October 17 and everything looked good. Then Wednesday, October 19, Owen got a fever. It was only 101.3 and the directives were that if he was over 102, come back to Philly. That night his fever only reached 101.7. I emailed the doc in the morning and since his wound was not actively leaking, we could stay home and wait it out. Maybe he just had a cold.

On Friday, October 21, I got up and got ready for work. I changed Owen's dressing and it was definitely actively leaking and I could see the metal in his back. I quickly called Nick and began to pack to head to Philadelphia.

We arrived in Philly and were admitted. Owen's wound was cultured and he tested positive for Staph gram negative, which is a very distant cousin to MRSA and one of those pesky bugs that likes to stick around. We scheduled surgery for Saturday October 22 for Dr. Campbell to take out the lower outcropping since it was coming through the skin and had contact with the staph.

On October 22, Dr. C did just that. He removed the lower outcropping, placed a wound vac in Owen's back and irrigated and debrided the wound. Surgery was again scheduled for later in the week to remove the wound vac, irrigate and debride the wound again and hopefully close him up. In the interim, Owen required Vancomycin and Rifampin- heavy duty antibiotics to fight the staph. He had to have a PICC line placed to deliver these antibiotics since they reek havoc on your blood vessels.

On Monday October 24, Owen went in for the PICC line under general anesthesia.

On Tuesday October 25, Owen went back in the OR to remove the wound vac and clean out the wound again. Dr. C felt the wound area looked great. He was able to get him partially closed, but we would be going home with an open wound. And by open wound, I mean that I can see metal and muscle in my sons back.

On Friday October 28, we were discharged with the PICC line and with the open wound. We had to learn how to flush the PICC with heparin two times daily and we had to do nightly dressing changes with betadyne and sterile dressings. And we did and we still do.

On Friday November 4, we had our first wound check-up with Dr. C. I removed Owen's dressing, thinking we had been doing such a great job. It looked a bit better to me and there was lots of pink skin that was granulating. But he took one look and said "oh no". Apparently, the skin is hardening around the edges and is trying to heal open. It's not healing from the bottom up as we would have hoped. In addition, the upper outcropping is poking too far out and threatening the integrity of one of the portions of the wound that is closed. Now, as of last night, the wound is leaking again.

Surgery is scheduled for tomorrow. We will go in, the upper outcropping will be removed. I am not sure if a wound vac will be placed and Dr. C will attempt to get this little boy closed.

It's a bit of a nightmare. And the craziest part is that these pieces have to go back in. Without the outcroppings, the ribs will shut on his lung. So Dr. C is going to see if he can have custom pieces made for Owen that will fit him. The insane part of this is that, this could happen every single time. No one is safe from these infections. We did everything humanly possible to prevent infection before the VEPTR was placed. CHP baths for Owen, Nick and I washed solely with Dial anti-bacterial body wash. Everything he or we touched was cleaned with clorox wipes. We really really did our best.

I am praying and hoping and wishing on a star that this is the last surgery. I will keep you posted!

1 comment:

  1. Thoughts and prayers for all of you. I can't imagine, and am continually amazed at both you and Nick. Love and hugs to Owen.

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