The New Plan

Our orthopedic surgeon came in to visit us tonight and give us more details about what to expect over the next few days.  So here's the tentative plan...

He will be out of town for the next 24 hours, so he will draw the sample of the fluid from Annie's back on Sunday morning.  That sample fluid will either be clear liquid, or it will be cloudy with puss. 

If it has puss, he'll know there is an infection in Annie's back that must be treated.  In that case, Annie will have surgery either Monday or Tuesday and he will open up the full length of her back again, as he did for her spinal fusion surgery, so he can gain access to her spine and the rods.  He will flush out the bacteria and remove any portions of cadaver bone grafts that didn't fuse from the surgery.  Annie will then have to be on prophylactic antibiotics for a year.  If she develops another infection in her back after that, they would go in again and remove all of the hardware to prevent further infections of the rods.

Infection in her back and on her rods is particularly dangerous because there's no blood supply to that hardware in which IV antibiotics can travel to, which makes these kinds of infections after a spinal fusion so difficult to treat. Also, because Annie has been on antibiotics for a week, the cultures of the fluid might not grow very well, which would make it difficult to determine susceptibilities and which antibiotic would be best to help treat the infection.

On the other hand, if the sample of fluid collected from her back is clear with no evidence of puss, then we're in a rather tricky situation.  It would be a good sign that there is no infection in her back yet, but it would also mean that infection could come soon.  The doctor didn't give us a clear picture of what would happen in this case of the fluid being clear, but honestly, he didn't spend much time discussing this scenario because I believe chances are rather slim that the fluid is clear.  It's most likely that there is infection in her back because of the persistent high fevers that continue despite all the IV antibiotics she has been on for a week now.

I know I'm beginning to sound like a broken record, but we really would appreciate prayers for Annie over the next several days, and prayers for our own peace and strength as well.