Tuesday, August 30, 2011

Updates part 2

So Zach's infection is looking a lot better, no more positive blood cultures since friday. No more fevers since late saturday night. That is so good, for once his infection cleared without having to pull his line. On another note, sunday when he nurse gave him his meds, they immediately came back out around his j tube stoma. Which has never happened before, it has been leaking excessivley since tuesday of last week but I had never seen it do this. So they scheduled him for a ct scan on monday morning to check his abdomen.
Monday morning came and they decided that a ct was not the best option, but another test called a double contrast study would work better. So he went down to have that done at 1pm. They injected barium contrast then air into his j tube and watched it move...or lack there of. I knew something was up when the dr left to go get another dr, the barium was just not moving down his intestines like it was supposed to. So they took xrays at 2, 2:30, 3 and then 4:30. I had to go to Zach's benefit last night so my mom (nana) talked to the dr's when they came by. They said they see a possible partial obstruction on the xrays. Apparently even after that long, barium was still in his stomach (which shouldn't have been there to begin with) and in his small intestines and it should have passed all into his large intestines at the point. So they were going to talk to his surgeon.
This morning they came by and had talked to surgery and decided it would be best to place a small scope into his j tube site and see if they could see the obstruction first before performing a big surgery. So he had that done this morning at 11.
This test showed that his roux en y was possibly the issue. The GI docs think that it is too anterior and the balloon of this button is blocking his intestines forcing formula back into his stomach and pooling around the tube. He also couldn't get the scope into the stomach portion of the roux en y so that might also be a problem . The plan is to place a longer j tube in tomorrow in intervential radiology under sedation. This tube will bypass the roux en y and hopefully make a difference. If not, if he still has pain, or vomiting or leaking then the surgeon will go in and look.
He has also expecting a visit from immunology to check on his dropping wbc. They have been trending downwards this week, it is at 5. He is also showing a big dip in his hemoglobin, it is now at 8.9. And this morning his blood sugar was 41 which is really low so that is all new. It came back up but it is very strange and new issue So we will see what else this week holds. He will be here through at least monday due to the iv antibiotics.

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