Irrigation and Debridement Surgery #2 Done

Dr. Hasley came to talk to us after surgery and said everything went well.  He only opened up the lower portion of her back (about 8 inches) where the most pus and infection was located last Monday.  Her tissues looked good today.  He flushed out the site with about 4L of fluid and removed a few more pieces of loose bone graft.  He also removed a cross-bar connecting her two metal rods since it was unnecessary and was most likely heavily contaminated. As he was closing the incision, he said there was much less pus oozing out of the tissues than on Monday.

Annie did well during surgery--much better than last Monday.  Her blood pressure remained much more stable, making things much easier.  She received only one unit of blood and at the end of surgery had a hemoglobin of 8.0. She had to receive normal saline IV fluids during the procedure, so her sodium levels went up slightly to 151 and 152, but she's back on half normal saline, so her sodium levels should start to go down again.

Since Annie's veins are all shot from so many IVs and blood draws, the only place they could find to put in an IV to start surgery was in her chest.  But that has since been removed with the placement of her long-term central line.  We're excited to have that central line and no longer have to worry about sticking her for blood draws.  The surgeon mentioned it was purple, and I thought that meant just the tip of the lumen, but the whole entire thing is purple--the tubing, the lumen, the clamp, and the brace that's stitched to her skin!  It's really not that big of a deal, but for some reason that just seems more fun to us and I think Annie will think that's pretty cool too... once she wakes up.

New purple central line that Annie will have for a year for her IV antibiotics.

Dr. Hasley talked to us for about 45 minutes in the lobby after finishing her surgery.  He's such a great guy!  It's just like sitting and talking to a good friend.  He's so nice and personable.  He started telling us about the few other cases of post-fusion infections he's had to deal with.  It was interesting to listen to, but also made me a little nervous considering Annie's high risk of recurring infection.  He said that even getting a UTI or bad acne can cause infection to seed on the rods, so he suggests that Annie be on prophylactic antibiotics for UTIs from now on.  Prophylactics for UTIs were what caused her c-diff infection 3 years ago, so we're not thrilled about that idea, but maybe this time we can have the infectious disease team figure out a better drug that would put her at less of a risk of c-diff down the road.

Dr. Hasley generally said that things are going well, however, Annie is one of his trickier cases because she was treated with antibiotics before finding the infection... which means that the cultures from her back won't grow anything...  which means they don't know what antibiotic to put her on to continue treating the infection... which means they have to put her on very broad-spectrum antibiotics to cover a multitude of things that might be causing the infection...  which means those broad-spectrum antibiotics can cause other complications by killing off too many other bacterias--resistant bacteria or fungal infections can occur.

So surgery went well today, but Annie is definitely not out of the woods.  Dr. Hasley even admitted that Annie WILL have more hurdles to jump before this is all said and done.  And really, this will never completely be done.  Even once Annie is finished with her year of antibiotics and we've finished dealing with all the complications that alone brings, her chance of having another infection develop is very high.  If that happens after this year of antibiotics, then he will do another surgery to remove all the rods and screws from her back.

The scope of her problems seems so big at times, but we are trying to take just one day at a time.  It gets way too overwhelming to think about all the trials this next year will bring, but for today we are incredibly grateful that her surgery went smoothly and she is headed down the right path towards recovery.

Warning: This may be too much information, but on a humorous note, after we told Dr. Hasley earlier today about our difficulties in keeping Annie's dressings clean inside her diaper, he had the idea of placing a surgical plastic over the bottom part of her dressings.  The plastic cover is similar in feel to a plastic tablecloth and has an adhesive strip on one end of it that is placed at the lowest end of her incision, creating a flap of plastic that then covers the rest of her incision in her diaper area.  As Hasley was describing this to us he said, "It's essentially a mud-flap." To which I replied, "You mean it's a crap-flap."  We got a good laugh and our newly-coined term is now in use even with the nurses. :)  Gotta keep a sense of humor!

An organization came around to the rooms today to wish the kids here happy valentine's day and gave Annie another balloon as well as a cute polka dot blanket.  And Annie sweet friend Macey, who also has Aicardi Syndrome, sent Annie a valentine balloon too!  What a fun surprise!  It's so heartwarming to have such kind friends and know how much Annie is loved!  Thank you so much for continuing to pray for Annie and our family, and for everyone's kind expressions of love and support by email or Facebook or texts.  Sometimes things get very busy here, so I can't always respond right away, but please know that we read and appreciate every message and expression of love.

Resting after surgery