Infection Update Continued

Brandt's infection is deep+serious.Surgeon reopened chest+added wound vacuum. He'll be intubated@least 1week. PTL he is stable.

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Sorry that last post got a little long, but quite a lot happened today. As you can tell from the mobile update I posted (above), it turned out to be a good decision to go to the OR. They actually took Brandt back around 12:15, and both the surgeon and anesthesiologist still felt they would just have to sedate, poke around, and flush the wound with antibiotics. But if they did find anything worse, they would go ahead and open the incision itself and worst case scenario, his whole chest and breastbone area. They said it would probably take an hour or two unless they had to go the anesthesia and surgery route. They asked us to wait in the PCICU waiting area so they could update us, but that they would plan on taking him back to the recovery floor unless it turned out to be something more serious.


So around 1:30 I asked one of the ICU staff to check the status--they hadn't given us a pager or anything since it was expected to be a short procedure. She said they were finishing up, didn't know the status of things, but thought that was a good sign that it had only been an hour and a half. An hour later we heard they had taken him back to ICU...at that point I figured they'd had to do a deeper sedation but still didn't expect at ALL what Dr. Bradley had to tell us when he came out to the waiting room.

He let us know that the infection was deep and what he would call serious. He was very surprised at how far it had progress for a couple reasons. There had been no fever or even outward sign of the infection until Weds morning. Plus he said this kind of infection usually would not develop until 2 to 3 weeks post-surgery. This one was only a week post surgery. He explained they'd had to open up not only the incision but also the breastbone/chest cavity again. He expressed disappointment at this development because he had done so well with the actual heart repair through the Bi-directional Glenn procedure.

By this time I was a little in shock to try to ask what all this meant. But he did warn us recovery can take quite a while. Once infection has gotten into the wound it's much more difficult to get it to heal without further infection, and of course, they have to keep it from spreading to the heart and lungs as well. So he installed something called a wound vacuum into the incision. He told us it looked like a black sponge with a hose attached to literally vacuum all the drainage out of the wound as it heals from the inside out. They will change that every two to three days and check for healing at that time. But I was really dismayed to hear he would have to be back on the vent...our last time with the vent hadn't gone too well because he hates it so much. But he had never had to be on it for long periods of time before. I misunderstood how long he said he'd have to be on the vent...I thought he said at least a week, but the nurse explained it would only have to be until the first vacuum change. The main concern was that even though he's been breathing well on his own, until the tissues started to heal inside and formed a seal around the chest cavity, he could actually take a breath while they were changing the vacuum and damage his lungs or spread any further infection into the chest cavity. Once that area started to heal, they felt he might be able to get off the vent following the first vacuum change on Saturday.

So that news encouraged me a little. We were both kind of reeling from the unexpected serious news, and Glenn was so good to remind me of Ps. 112:7--it came to his mind right away. "He is not afraid of bad news; his heart is firm, trusting in the Lord." That thought really steadied me. We know this is in God's timing...He knows it's Christmas, and that we were looking forward to being home with a happy, healing Brandt to enjoy the time with Joel and Seth being out of school. He knows we hate to see this little baby in pain and unable to help him. He knows how much I despise all these high-powered pain and sedation medications that were unable to calm Brandt on the vent before. And He still knows what is best...