Tuesday, February 19, 2008

Jack in the hospital

Jack's low grade fever continued to move up over the weekend and he never really developed any very specific flu-like or viral symptoms so we talked with Dr. Price yesterday morning and she told us to come on in to our local Children's hospital. When we got here, what really got all the attention is an area on his abdomen near but not at the incision site that started out a light pink and became angry red and splotchy. A CT scan of the abdomen showed some inflammation around the new shunt tubing and less inflammation around the old subdural shunt tubing. A CT scan of the head actually looked pretty good except an incidental finding that the ventricles appeared slightly larger than compared to his May 2007 scan. The blood work (ESR, CRP) shows some inflammation but interestingly enough his white blood cell count was not elevated. They also did a set of x-rays called a shunt series and that, apparently, was fine. They tapped his shunt. The cerebrospinal fluid was nice and clea!
r in appe
arence. They are waiting for the cultures to grow. It takes about 48 hours-you just have to give it time. The neurosurgery resident said this morning that it looks clear so far and that the gram stain was negative which is confusing. You can have a negative gram stain and still have bacteria. All bacteria is either gram negative or gram positive.
Jack has continued to have a fever throughout the night (102.6-102.8) and slept VERY restlessly. He babbled and signed for hours as he tossed and turned. He did not even sleep deeply enough to be put on the Bipap until after about 330. He has had two doses of IV Vancomycin (antibiotic) now. His abdomen looks a lot less angry.
The tentative plan for now is to remove both the old subdural and the new VP shunts, place a ventriculostomy (an external CSF drain), and do IV antibiotics. Jack will have to stay in the hospital until he finishes the antibiotics and they place a new VP shunt. He has to remain at one level position as much as possible. Every time he changes his position, the staff will have to clamp off the ventriculostomy and recalibrate. For those of you who have met Jack, you know that happy active Jack is not really one to lay around. We are hoping to keep him happy with his videos and books and quiet activities. The problem is that he really is not much into sitting down/laying down activities like coloring or playing with say blocks or other fine motor type stuff. Suggestions would be greatly appreciated. I'd rather that he not just be stuck with nothing to do..
Thanks for the hugs, thoughts, and prayers.

Sent from my Palm Treo

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