Sunday, April 05, 2015

Post-Operation Recovery

For the first week after the surgery to remove Molly's infected skin she was in the Pediatric Intensive Care Unit and on a ton of medicines to prevent any type of infection. I don't know exactly which ones she's on, when they started them, why they started them, and when they started taking her off of them. Things are so fast-paced here that I can hardly keep up.

At the PICU Molly eventually got to a point where her blood pressure was pretty stable and she didn't need quite as much of the medicines she was getting, so the doctors there decided that she could move back up to the ICS. Since they absolutely will not make exceptions for babies and siblings to visit PICU patients unless there are very special circumstances, I had some family sit in the PICU waiting room with Big Sis and Little Brother during the day so I could sit with Molly and then just pop out for a bit every couple of hours to nurse Little Brother and make sure Big Sis was behaving well enough.

Molly got transferred up to the 4th floor again after Daddy got back from work on Wednesday March 25th (5 days after surgery). Then the next day her ANC suddenly jumped up from 0 to 0.4! The Neupogen (white blood cell growth hormone drug) is working! She had a dressing change again, which meant no food for about 8 hours before. Molly doesn't seem to mind not eating anymore, but she still requests water often.

After the surgery, one thing we've been watching carefully is swelling of her abdomen. She had pretty bad swelling of her body and legs and feet which got worse until we got to the ICS, and there they gave her a diuretic which helped a lot with that. Currently she is not taking as much of the diuretic, and her swelling is still going down.

On the 28th, Molly's ANC went up to 2.5 (she's never really been up higher than 1.5 in the last two years, so this is a really big number for her! Normal is between 1.5-8.5.) Then it was 3.2 on the 29th, and 5.8 on the 30th, so they stopped giving her the Neupogen shot.

Doing well on March 31st, preoccupied with picking dry skin off her lips and fingertips.
As far as the open wound goes, they have been replacing the wound VAC every few days, but the plastics team have been checking for healing tissue around the wound and at first they were thinking of placing a synthetic skin dressing called Integra on her wound to help heal it until her body is strong enough to deal with a skin graft. Now they are telling us that they think her wound is looking good enough to be able to stretch the skin around it and just do a small skin graft in the widest wound area. This is very good news for Molly.

The oncologists are still concerned about the leukemia Molly still has to deal with, but they know that this open wound is the priority right now. They are pretty certain the last block of chemo got her into remission, but they aren't able to confirm that with a bone marrow aspirate yet because last week Molly got skin redness that started spreading at her wound and went up to her scalp in just a few days. Turns out she was having an allergic reaction to the antibiotic Meropenum and once we stopped giving her that and started a different antibiotic, the redness started going away. The oncologists are hoping to get an aspirate done this next week. They say that if the leukemia does start to have more of a presence again, they can use certain chemo drugs to hold it off for awhile while we finish healing this skin wound. They really don't want to subject her to more heavy chemo and radiation until she's healthy again.

The bacteria that they say caused the skin eating rash is pseudomonas. They also found this bacteria in her port implant, and it was proving difficult to get rid of with drugs, so they ended up removing her port during one of the scheduled dressing changes and placing a PICC line in her left arm. After a few days, that PICC line developed a clot at the end of it and so they removed that and placed a new PICC line in her right arm. Molly has been having some pains in relation to her wound and the PICC line and her swelling, so they have her on morphine still, and she has a button she can push to get another small dose of morphine every 10 minutes. She usually declines pushing the button though, saying all she needs is to rest and it will stop hurting. She's so strong.

Right now Molly is just hanging out in her room in the ICS unit, passing the time watching just about every animated movie made (Ratatouille is still a favorite, but she's watching Cars and Monster's University a lot too), and enduring the every-4-hours vital signs check and the constant visits from doctors from just about every department in the hospital. She's got the oncologists, the ICS team, the plastics team, the physical therapy team, the infectious diseases team, the dietitian, the urologists, the wound VAC and ostomy team, and several others I am probably forgetting. The trouble is that all these teams show up at different times from each other, and so she gets a visit nearly every hour from someone until the afternoon where we have a few hours undisturbed.

Molly had a rare energetic minute, and we played a modified version of pictionary. This is a cat she drew. Taken on April 3rd.
The Intermountain Healthcare system of hospitals lifted the flue season visitor restrictions on the 2nd of April, so now siblings younger than 14 can come see patients, and that means I can bring Big Sis and Little Brother in to Molly's room with me while I am there. This makes things so much more convenient!

Molly gets a lot of gifts sent to her, and she loves to open the packages, but she never really keeps the gifts for herself. She is more of a "quality time" kind of kid, so she's been regifting most of the stuff she receives to Big Sis or Little Brother. She really loves to give them stuff, it's so cute.

Sorry for the punctuated format of this post. As I mentioned, things are happening at a very fast pace and it's hard to find the time to frequently post, so my posts get written less frequently and I just have to try to remember everything that has happened. If you'd like, you can visit my Facebook page where I post more frequent Molly updates publicly.

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