Slow going

Today when we (and I use that term loosely) changed out the dressing around James' g-tube there wasn't much improvement from yesterday. The site actually has a larger area of redness than it did a day ago, although there didn't appear to be any more pus.

The results from the culture indicate that klebsiella is the bacteria culprit. If it gets into his blood stream, it could be dangerous, but they have, thankfully, been treating him with the right antibiotic, fortaz, all along the way.

We were hoping to start him back on tube feedings today, but after seeing the site, we were all (me, the doctors and the nurse) uncomfortable with putting anything in through the g-tube. The current plan is to wait until tomorrow so the GI doctors can look at it and tell us what they think ought to be done. Hopefully the wound/ostomy nurse will weigh in as well.

I have been concerned about James' fluid intake and we seem to have gotten a handle on that and now our focus is more onto his nutritional needs with the idea being that his body needs protein to be able to heal. I thought it was also interesting that the nutritionist wrote the order for his TPN (Total Parenteral Nutrition--essentially IV feeds) to include extra zinc because it is known that zinc helps with the healing process.

James' counts are really good and if this wound around his g-tube site wasn't an issue he would get his next chemo this Thursday. That means this was supposed to be our week off! However, Dr. Keller wants to wait and see how James heals before he decides if we will postpone the next chemo treatment.

James still seems pretty weak. This is due to temporary nerve damage caused by vincristine (a chemo drug). As the nerves regenerate, he should be able to increase his activity and regain his muscle strength.

Please pray for wisdom and timing, and thank the Lord with us for the wisdom he gave the doctors to put James on the fortaz in the first place, especially since they didn't initially suspect klebsiella. Pray, also, for his complete recovery from the vincristine side effects.

Thanks for checking up on us. We sure appreciate your notes and prayers on ours and James' behalf.

Love, Stephanie