Dr. Hanley came to see us today, and it was the talk of 3 West. Our nurse had never even seen him before and was asking me what he looked like! The great plan we've been waiting to hear is to wait and see. Are you kidding?! I hate waiting! Dr. Hanley says that it's very difficult to tell a normal pocket of fluid that is present after surgery from an infected pocket. He doesn't want to jump right into surgery unless we are sure that there is an infection, because it would mean cutting through his incision that we already know is infected and that would not be a sterile situation. We could use an ultrasound and a needle to try to suck up some fluid and culture it, but even that would require a good amount of sedation and the abcess is right next to his heart so there is some risk in doing that. So the idea is to treat the infection we can see, since we're not going home until that is taken care of anyway. That means we continue the IV antibiotics and recheck the wound every seven days. Once it looks good enough to discontinue antibiotics we hang around for a few more days to see if Drew develops a fever, his white blood cell count or CRP levels increase...basically we wait and see if he gets sick. The attending cardiologist on the floor was also here and said that sometimes these infections take 4-6 weeks to treat--we are finishing our third week of treatment.
So, I asked about transferring to a hospital in Sacramento so we could at least be closer to home. Dr. Hanley didn't like that idea a whole lot. He said he feels responsible for Drew's care, that Drew has a very complex cardiac repair, and that here Drew has doctors that know him the best. While he doesn't think there is a very likely chance that Drew will take a sudden turn for the worse, if he does he would like him to be here. I'm not sure that I agree that we've got the doctors that know him best here, since our cardiology team at UCD has been caring for him for four years, but I guess he probably does know the inside of his heart the best. So I asked if it was possible for us to go to Sutter (which I'm not sure that it would be with our insurance) since Dr. Mainwaring is there and was present for Drew's surgery. Dr. Hanley said he would feel more comfortable with that if that's what we want to do. So we have to decide and if we do want to move forward with that plan they have to check with Dr. Mainwaring and make sure it's ok with him (I think it is) and that he's not planning any vacations or anything. Dan and I need to discuss this in further detail before we decide what to do.
Also, the ID (infectious disease) doctor came by after we had our talk with Dr. Hanley and pretty much said he disagrees. He thinks it is an infection and that surgery is the best treatment, but he will defer to Dr. Hanley and try to tailor our antibiotic therapy as best he can. He didn't sound very confident in that plan though.
In other exciting hospital news, Drew had two friends come visit today. Jacob, Eben and Drew had a lot of fun together. It was great to see Drew acting so much like his normal self, running around chasing them, being silly and riding his bike. He also had fun this morning with his squirt gun outside shooting all the plants and trees. And he got to go the gym today for his PT and got to play with an obstacle course, throw and kick a ball and play basketball. I'm telling you, this kid is ready to go home!