Thursday, December 6, 2012

CSF bacteria, Infection,

The Resident came in very early this morning (1-2am) to let me know the 2nd CSF culture was also positive and they where oig to start IV antibiotics as well as talk to teh Infe4ctious Disease drs and get a consult from them what they suggest. The culutre will have to grow to see what the bacteria strain is so they know how best to treat it which can sometimes take a few days, I am unsure. Once Dr.Bragg stops by I should know more; she is in clinic this afternoon so I am unsure if she will stop by this morning.   ....

**Later Thurs night, Dr.Bragg stopped by late this afternoon and talked about the whole situation. She first found out about the infection around Midnight Weds night/Thurs morning when the Resident called her with the results. She asked Infectious Disease to consult on my case but ive not yet seen them, I am thinking they have talked to her though as one dose of IV antibiotics has been run already. (daptomycin). Dr.Bragg's tentative plan (she wanted to think over it more tonight) was that we would do IV antibiotics for the next days and she would look at her surgery schedule + perhaps already on Monday she would book an OR to take out both shunts (LP and VP) as well as disconnect the ventricular-distal drain (which is part of the VP shunt) and place a EVD which we would drain from in place of the shunts for probably close to a week or so (maybe even as soon as the end of the week) in between which we would cont the IV antibiotics and then she wasnt sure if she would replace both shunts at once (I think I got this part right) or if she would do one at a time in separate surgeries - I need to ask her that again as I cant remember for sure. She does not plan on placing either shunt in the exact locations and said she would likely place the VP shunt in to a different ventricle although I am unsure would she thread it down the same side (I imagine so as I have the Port on the other side) and then she said she would very likely place the LP shunt up above the previous scar which goes from L1 or 2 down. I think she said she would create a new incision up above where we've done all of the previous lumbar surgeries and I am unsure if she would still re-thread the catheter up to the upper thoracic spine levels. After this we would wait and watch and heal while doing whatever amount of antibiotic Infectious Disease recommends.  The infection itself is a slow growing one but we know is not from this last surgery on Monday as there showed moderate amounts of the bug in the tested cerebral spinal fluid (CSF).

I'll update when I know more - please pray I dont go stir crazy and that this all goes well and that Dr.Bragg in her often infinite wisdom is able to make a fit and working plan and that her patience continues as with her I feel better about this all although honestly id rather not be dealing with it.
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Erica

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