Posted by Becky
We got some more info from the doctors before they wheeled Leif off to the operating room.
Although they got some information from the CT scan, it's not clear whether there is an actual pocket of fluid in there, or just generalized inflammation and swelling. They'll use an ultrasound in the OR to see for sure. If there is no pocket of fluid to drain, they won't cut anything, just send him back upstairs and hope for the antibiotics to take effect. If there is fluid, they'll drain it and take a sample to culture, to see if they can determine the specific bugs causing the trouble; that will help them target the infection with the most effective antibiotics.
Speaking of antibiotics, it turns out they're giving Leif daptomycin after all; his IV antibiotics are daptomycin for skin flora every 12 hours, and meropenem for gastrointestinal flora every 8 hours. They figure he's most likely infected with either skin or gastrointestinal bugs (or both) due to the location. These new antibiotics have not had time to take effect yet. They have stopped the Zosyn since it was not controlling the infection. He's still getting acylcovir and voriconazole, although not specifically for this infection; they're preventative treament since he's been immune suppressed for so long.
To keep things exciting; if the timing works out, they find they don't have to cut him open, and the right doctor (Dr. Manda, a hematologist/oncologist) is still available, he will do a bone marrow biopsy in the operating room while Leif is there and conveniently knocked out. If Leif's blood counts haven't come up by Monday they have been planning do a bone marrow biopsy then or Tuesday, to see if they can determine the cause. If it works out, it makes sense to take the opportunity to do it today instead.
Leif's neutrophil count went from 0.000, where it's been since finishing his chemo, to 0.110 this morning. His total white blood cell count has been and remains 0.2; now slightly more than half of those are neutrophils, which are the good/functional guys. If his counts start coming up nicely, they won't do a biopsy on Monday after all.
We got some more info from the doctors before they wheeled Leif off to the operating room.
Although they got some information from the CT scan, it's not clear whether there is an actual pocket of fluid in there, or just generalized inflammation and swelling. They'll use an ultrasound in the OR to see for sure. If there is no pocket of fluid to drain, they won't cut anything, just send him back upstairs and hope for the antibiotics to take effect. If there is fluid, they'll drain it and take a sample to culture, to see if they can determine the specific bugs causing the trouble; that will help them target the infection with the most effective antibiotics.
Speaking of antibiotics, it turns out they're giving Leif daptomycin after all; his IV antibiotics are daptomycin for skin flora every 12 hours, and meropenem for gastrointestinal flora every 8 hours. They figure he's most likely infected with either skin or gastrointestinal bugs (or both) due to the location. These new antibiotics have not had time to take effect yet. They have stopped the Zosyn since it was not controlling the infection. He's still getting acylcovir and voriconazole, although not specifically for this infection; they're preventative treament since he's been immune suppressed for so long.
To keep things exciting; if the timing works out, they find they don't have to cut him open, and the right doctor (Dr. Manda, a hematologist/oncologist) is still available, he will do a bone marrow biopsy in the operating room while Leif is there and conveniently knocked out. If Leif's blood counts haven't come up by Monday they have been planning do a bone marrow biopsy then or Tuesday, to see if they can determine the cause. If it works out, it makes sense to take the opportunity to do it today instead.
Leif's neutrophil count went from 0.000, where it's been since finishing his chemo, to 0.110 this morning. His total white blood cell count has been and remains 0.2; now slightly more than half of those are neutrophils, which are the good/functional guys. If his counts start coming up nicely, they won't do a biopsy on Monday after all.
Following closely Becky. You're right....very emotional day for you and Leif. Do hope those neutrophils keep climbing! Go, go, GO!!!
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