So Happy to Finally Consult with Our GI!

I was so thrilled when our GI, Dr. Kunnath, came to visit us today!  He gave us excellent news and peace of mind!

We've been concerned that Annie still might have an issue in her colon with a possible colitis flare-up or something else, since her calprotectin level (that measures inflammation in the colon) was high at 448.  However, Dr. Kunnath said he had reviewed all her tests and scans and said that anyone with a diagnosis of ulcerative colitis, which Annie has, their calprotectin baseline will always be higher than an otherwise healthy person.  He suspects that Annie's baseline is around 200-300, but given the antibiotics she's on and diarrhea she's having, he's not surprised or concerned that her calprotectin is 448 (normal would be below 50 in someone without ulcerative colitis).

Also, to put things in perspective, he reminded us that Annie's calprotectin was 2,500 when she had her major c-diff infection and ulcerative colitis flare-up 3 years ago landing her in the hospital for 6 weeks.  He said a calprotectin of 448 is not indicative of a flare-up in a person with ulcerative colitis.

Dr. Kunnath said that since her CRP (marker for inflammation in the blood) has come down from 27 to 5 in just a week's time on antibiotics, is another indicator that she does not have a colitis flare-up, otherwise her CRP would still be high and remain high until the colitis is back in remission.  He also said that since the sigmoidoscopy was negative for inflammation, it is not likely that there is any inflammation higher in the colon since colitis typically begins at the rectum and works its way up the colon. And her Upper GI scans showed no evidence of inflammation in the small bowel either.

He believes her initial change in BMs before we got to the hospital was a response in her colon from having her spine infected and that the diarrhea only worsened at the hospital because of the antibiotics she is on.  Zosyn is notorious for causing worse diarrhea than other antibiotics, so I'm glad we'll be stopping that one soon and switching to some different ones for the next year, although diarrhea still might be a long-term issue while on the antibiotics.

So Dr. Kunnath said we shouldn't be concerned if she continues to have some diarrhea over the next year while on the antibiotics, but we need to call him if we start smelling the unique smell of c-diff infected stool.  He's not thrilled that she'll be on powerful antibiotics for a year, but agrees that the infectious disease team is taking the best course for trying to prevent c-diff over this next year with the culturelle and oral vancomycin.  And Dr. Kunnath wants to follow Annie regularly over the next year to make sure that her colon doesn't develop any problems too.

I'm so relieved to hear this news today--that Dr. Kunnath strongly believes there is no evidence of any kind of colitis flare-up.  He is such a great doctor and is so easy to talk to.  I'm so glad he is concerned for Annie and wants to see her regularly over this next year.  What a blessing wonderful doctors are!  And what a relief some good news around here is! 

Annie tolerated her wheelchair today for 5 hours!!  And since then she has been sleeping like a log with her CPAP on!  I'm so happy that she's finally decided to sleep since she really hasn't slept at all the last 2-3 days. 

Dr. Hasley (orthopedist) came back to visit us later this afternoon after looking at Annie's CT scan from this morning and said that all the screws in her back look just fine and he won't have to remove any of them.  There are still just a couple that penetrated a little deeper than he would have liked, but they aren't close to her aorta--just her lungs! But he said that's no big deal. So on Friday afternoon Annie will just have the lower half of her incision (about 8 inches) opened back up to clean out more pus and infection.  Dr. Hasley said that the lower part of her back wasn't the only area that was infected, but that was where all the pus collected because of gravity.  So he'll go back in on Friday to see if any more pus has collected in her lower back.  She'll have another drain in for several days after that procedure as well, to let that site drain, but said there's no reason we couldn't go home with the drain in.  However, I think it will take a while to get Annie switched over to a new antibiotic regimen, and monitor her on that for a few days as well, so I don't anticipate being out of the hospital for another 10 days or so.

So today has definitely been a good day.  And in just a couple hours, Justin will finally be back from his trip too.  We love days that bring happy news!