While Noah's labs look rough, he continues to look reasonably good. He's obviously not feeling well at all but is not what we call "scary sick." He's able to be awake and alert which is very, very good. He has refused to complain even when he's too wiped out to even sit up and actually said he didn't want us to be worried about him. He is such a dear little guy.
We got back urine culture results this afternoon which is VERY fast. He's growing > 100,000 of gram positive cocci (very probably MRSA but we'll know more once we have an ID and sensitivities.)
In plain English, when Noah is sick, sterile samples of blood and urine are drawn and put into a growing medium - think of growing bacteria in a petri dish. The samples are checked periodically to see if bacteria are actually growing (they shouldn't). If bacteria grows, they count the number of bacteria in a tiny specimen - maybe 1 ml? Above 100,000 definitely indicates a significant infection and in fact they stop counting at that point.
If you follow that though, you'll realize that the faster the sample hits > 100,000, the faster it is growing and the higher the numbers are altogether.
Right now we have a very broad, general idea that the bacteria is "gram positive." This is very generic - like calling a living creature a "mammal." As the bacteria continues to grow in the lab, they will precisely identify the bacteria - say, a flying squirrel vs. just a mammal. They will test Noah's actual sample with drugs that are typically effective for that bacteria and see which ones actually work (genetic mutations and resistances mean that a specific bacteria growing from YOU might not respond to the same stuff growing from ME). These are the longed-for "sensitivities" and it tells us which drug(s) will be most effective fighting this exact infection for this exact boy. We mark off the ones that cause serious allergies and pray that there will be a good one left on the list, then pray his liver and kidneys can handle it.
I hope that makes sense. We tend to toss out phrases that are familiar to US but not to many of our readers and I am sure it is confusing at times.
It is very, very disconcerting that we only cultured Noah's urine because of his viral infection (cough). We'd noticed abdominal pain but in the absence of fever that probably wouldn't have let to a full battery of labs until it had gone on for several days at least. I would expect him to be acting far sicker with this kind of infection and we really aren't sure why he isn't mounting an immune response of any kind. His white count is very low and he's just really not doing anything to fight back. On the upside, he also isn't terribly sick and I really have no doubt that he'll respond to antibiotics and be right as rain before too long.
It is very possible that this infection is a result of his broken supra-pubic catheter almost 2 weeks ago. There was a small piece of the catheter balloon missing and if it's in his bladder it be the culprit. It was very small and is clear and thin (think Saran Wrap) - while the surgeon didn't see it in his bladder, it would be hard to spot and easy to miss. As a reminder, that broken catheter was an EQUIPMENT failure and not the fault of any of his medical team. It was just one of those things that can happen.
Noah is fairly agitated from the steroids/nebulizer treatments. He's not being ugly or mean or aggressive - just totally hyped up and agitated. His philosophy today has been that if something is worth saying, it's worth repeating about a bazillion times LOUDLY. He's had the attention span of a tsetse fly and the impulse control of a rabid racoon. He's being as sweet as he can be and very, very loving - but very exhausting at the same time. Our precious youth pastor truly showed the love of Christ in action today by coming over and playing (really playing) Legos with Noah for nearly 2 hours. His nurse and Jeff and I are simply exhausted and could not have played in such an energetic and involved way. Noah adores Dave and just ate up the attention . . . . and we all got a bit of a break from the agitated behavior.
Please just continue praying. Our pediatrician is coming by in a little bit to check on Noah - I don't expect any big news or changes but will update if there are any.
Blessings,
Kate
