Office visit 9/21

We came straight to the office from Morgan's Wonderland where we had been taking pictures. Alan was having a good time when all of a sudden he started crying and holding his stomach. We had an appointment early in the afternoon, but after calling, came in right away.

Alan was dehydrated, hot with a fever, and showing signs of infection. Based on yesterday's cultures, the docs want to continue fluids for hydration, IV antibiotics and Toradol for the pain. The additional hydration will be added to Alan's TPN. The course of antibiotics Alan needs is usually done in the hospital, but Doc P saw that I was not happy with that option. I am so afraid that if Alan goes into the hospital, he will never make it out. Instead, he will order the Vancomycin from Coram, our home health infusion company. We will get one treatment in the office, then Coram will deliver the rest to our home for us to administer. Our nurse Chris will come by the house to show us how to set it up. It turns out the vancomycin will be dispensed in an elastomeric pump similar to the Eclipse balls we use for his normal saline every day. No need for yet another pump and backpack.

In addition to the newly TPN formulation and antibiotic, we waited for Doc P to be free so he could flush Alan's nephrostomy tubes. None of us were happy with the output and were concerned that they were clogged (and possibly clotted because of the blood we were seeing in the bags). It meant more delay. This was something that Doc P wanted to do himself, so we had to wait until he was free. He flushed some normal saline into the lines several times, then put in some TPA. Hopefully this will do the trick.


"Come on Doc P! I have places to go..."


He's here!


"Good job Doc P! Now let's put these bags away..."