This morning I was so upset with myself because I woke up 10 minutes too late to call and get the night nurse's report on how Brandt had done...so I gave them time for shift change and called and was not pleased when they informed me his nurse was "busy" and couldn't come to the phone. I told Glenn I thought something was wrong, and sure enough, when I called back in 15 mins as they instructed, they told me he had extubated himself again. Even though we warned them about his ingenuity in pulling things out...even though they were giving him extra sedation...even though his arms were restrained. He had thrown his head back and thrashed the vent around with his tongue again. Only this time he had to be reintubated because the vent had to be in for the wound vac change.
I just HATE him having to go through all this again...but they got the tube back in, stopped his feeds again for the vacuum change, and gave him even more sedation. I had been dismayed to learn that his surgeon, Dr. Bradley, would be out of town until Wednesday of next week. Dr. Bradley found Glenn in the waiting room last night and let him know he was going to be gone, but assured Glenn that he had briefed the other surgeon on the plan and that he would be keeping a close eye on everything until Dr. Bradley's return next week.
In the middle of all the commotion with Brandt extubating himself, my Mom was arriving with the boys, and we were SO excited to see them. Also some friends from church got here, and it was great timing because they were able to remind and encourage us that even the change of surgeons, the premature extubation, all of it is for a reason! They brought a sweet sweet card and gift from the church...we have been so surrounded by the love and care of family, friends, and extended church family...we feel blessed with so much prayer support and God's protection and comfort even through a serious and scary infection like this. I mean, I could start a huge list of "What Ifs" that God DIDN'T allow!
So the other surgeon reported after Brandt's wound vac change that everything looked to be healing well and very clean. A good seal had formed around the chest cavity, so they were able to extubate him, which was a WONDERFUL thing--one less tube for him to deal with. He was still on a feeding tube, which was helpful for all the oral medications he is on. Another problem following his Glenn surgery is that he developed a huge adversity to taking all his meds--the only thing I can figure about that is that he got something nasty tasting following the surgery, so at least when he gets those through the feeding tube he doesn't puke them up!
Best as the cardiologists could explain to us, the plan is just to continue to let the antibiotics work and keep the wound vac in until they are sure everything is healing without infection. However, they also admitted that it will be difficult to tell if there will be a recurrence of the infection until the incision is closed again for several days and they can still monitor white blood count etc. His infection is a strain of staph that showed up a day or two after they took the cultures during the wound cleansing on Thursday. He had two obvious areas of infection at the top and bottom of his incision, and Dr. Bradley primarily needed to open the breastbone because these two areas "communicate" with each other to spread the infection the length of the incision and then as it goes deeper, into the chest cavity. In addition to the antibiotic cleansing, he also removed some suspicious tissue and bone areas to be sure everything looked fresh and new. We are so thankful the infection hadn't moved deeply into the bone, chest cavity, or bloodstream, as that would have made his condition and recovery even more serious and widespread. The infection had to have been caused during surgery as it developed too quickly to have gotten in from an outside source...the hospital personnel do everything they can to maintain a sterile environment, but this kind of infection is of course a risk of any surgery. Also as far as they know, it's not a resistant strain. Dr. Bradley will eventually decide how long his course of antibiotics will need to be...I was horrified to hear them mention 4 to 6 weeks, but they quickly assured me he could go home with the PICC line to continue antibiotics at home if the incision is healing and the wound vac can come out.
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