August 14, 2024
August 14, 2024
If felt like a lot was accomplished today for an inpatient day and after a long night, we are tired!
The second culture drawn yesterday did grow as well, so any tiny bit of wondering left if this infection was a contaminant is off the table. The bacteria is streptococcus mitus. One that can live in the mouth. They believe this translocated from Tates mouth into her bloodstream through a cut or sore in her mouth. In healthy people it’s not a problem, in immunocompromised people, it can cause big issues including an infection that settles in the heart.
Tomorrow will likely bring an echocardiogram. Elevated HR and some arm pain tonight makes it even more important. Tate has been on 2 IV antibiotics and today they switched to just one until sensitivity comes back in 2-4 days. She wasn’t feeling as well today so we’re hoping things are still headed in the right direction.
Usually, cultures are drawn daily. But with that culture bottle shortage, they’re being drawn every 48 hours. If things don’t clear, that could drastically lengthen an admission. She’ll be drawn again tomorrow morning and we go from there.
Tate did get day one of IVIG today and the second will happen tomorrow. These immunoglobulins are donor antibodies that help her fight infections and are especially helpful when she is sick. She spends two long 7 hour infusion days out of every 21 getting IVIG. She’s been getting this since she was 10 years old.
We had a care conference today with the medical team, rheumatology and hematology. Once this infection clears, Tate will have a bone marrow biopsy to see if that gives any insight into her cytopenias (low blood counts.) If that looks as we hope, it’s likely an autoimmune issue that we can’t/won’t address within the bone marrow but more externally in the bloodstream. Neither are good so we’d be happy with just a clear direction, which we were told today is unlikely. What we do know is out of 3 blood infections in the last 3 months, 2 were translocations from within her body. Meaning they didn’t really have anything to do with her central line. But everything to do with leaky tissues and an inability to fight infection. That third infection will remain inconclusive. This is dangerous for tate and more time in the hospital than any of us want. So we keep working for something better.
We had a familiar and favorite nurse and CA today which always makes the day brighter. I got to have breakfast with a sweet friend who’s daughter’s inpatient schedule finally overlapped with ours. And Tim was able to come spend some time with us. Lots more good to focus on than to sit in the hard today. I always feel better with a plan, so we’ll take it.