Day 229 - Delayed Intensification finally strikes

     The last couple of days have been a whirlwind of emotions.  When I got home last night Cristy alerted me to a potentially infected area around Evan's PICC line that was discovered during his weekly dressing change by the at-home nurse.  This is particularly troublesome because it basically allows bacteria direct access into his bloodstream.  We called the CHoA Oncology on-call and he suggested coming in to have it looked at.  Cristy and Evan went to the ER last night to have it examined and while red and irritated, the nurses felt it was in decent enough shape to re-dress.

Releasing the butterflies that we helped through metamorphosis.

     Once Evan and Cristy got home around 11:30 we gave Evan a quick snack and quickly prepped him for bed.  While I was reading to him I noticed he kept scratching and tampering with his bandages.  I asked him to stop and told him that going to sleep might be best.  About 10 minutes later we heard a blood curdling scream and Evan had scratched half of his dressing off exposing his PICC line and wound.  Cristy scrambled to re-cover and again we were prepared to visit the ER.  The on-call doctor told us to keep an eye on it and try to get it properly covered in the morning.
     We checked Evan last night, this morning and throughout the day, but didn't notice any changes to his wound site, so we've just assumed that we had managed to dodge a bullet.  Cristy and Evan left around 11:00 today to head to Evan's MRI appointment.  The intent of this was to check for bone growth and blood flow in his ankle.  This has been hard to see in an x-ray because the radiation blurs out cartilage, veins and ligaments.  We heard back from the surgeon just before dinner and needless to say his news was not what we were expecting.

     The surgeon discovered that Evan's leg has multiple infections.  His ankle is re-infected and now there is a pocket of infection below his kneecap on the proximal tibia.  As of right now the plan is to get admitted into the clinic tomorrow at 8:00 a.m, where the Oncology team will direct him over to the OR for an operation on both spots of his leg.
     All of this came as a surprise so we didn't have a list of questions prepared.  What I can tell you is the surgeon said that blood flow appears to be fine, but stunted by the infections in his leg.  Cristy asked why we hadn't noticed inflammation, redness or swelling typically associated with an infection and he stated that without white blood cells to kill the bacteria you wouldn't see these symptoms.  Thinking the worst this obviously makes me wonder just how big of a problem we're dealing with here.  I'm afraid we won't know for sure until his white blood cells bounce back.

     Not confirmed, however I'd expect that we'll be in the hospital for at a minimum the remainder of this week for observation and to closely track his blood counts.  ID will almost certainly be front and center again as well as we determine how best to treat the various pockets of infection throughout.  I don't know what I had expected to hear today from the doctors, but this took the wind from my sails.  Cristy is visibly upset and we're trying to take it in stride and stay strong for Evan.  My parents have agreed to watch Nolan for us so that we can focus our attention on getting Evan healthy.  Time to face adversity again and see what we're made of.