Day 231 - Culture Club

     This morning around 7:20 Evan was taken upstairs to the operating area to have his right leg operated on (again).  The surgeon came down at about 9:30 to let us know that the surgery was a success.  She was able to collect some tissue and pus for the biopsies and relieve the pressure in his bone.  Historically we haven't had much luck with the cultures showing bacterial strains, but because there was pus and original tissue I like our chances.  Evan has spent the rest of the morning sleeping off the anesthesia.
     The ID team came down around 11:00 to let us know their immediate findings.  Under a microscope the doctor saw gram negative rods, consistent with e-coli, however there were other organisms that she wanted to take a closer look at.  While our surgeon is not an infectious disease doctor, she feels very strongly that we're dealing with two different strains here and has stressed her thoughts to the ID doctor.  We're expecting another visit from ID very soon, hopefully with more concrete findings.

A little groggy after surgery.

     It's been a slow day as Evan recovers from his operation.  While under he received a spinal tap to draw fluid samples and another dose of chemotherapy.  By consolidating the efforts this morning it keeps us somewhat on schedule with his cancer treatments.  This afternoon he got an infusion of Rocephin and IVIG.  His temperature has been steadily climbing today, but since it wasn't a spike there isn't a concern right now.  Anesthesia, antibiotics, IVIG or improved WBCs could all have contributed at this point.
     The orthopedic surgeon did bring us some good news today.  She conferred with her colleague, who has also been involved in Evan's care, and they agreed that they feel his ankle has improved enough to begin walking on it again.  As soon as Evan feels up to it we can start incorporating walking into his PT plans.  She cautioned us that the bones in his right leg were "soft" due to being off of them so long.  Cristy and I will work out a plan with his physical therapist to address this short and long term.

The newest drainage line in his leg.

     Some uneventful days would be ideal to allow his body time to heal and get us back on track with Interim Maintenance.  Tomorrow I'll talk to the oncology team to talk about timing for the next steps.  The rounds of chemo from here on out should be much less toxic to Evan's body and keep his blood counts in a much safer range.