Apparently Sam missed all of his lady friends at the hospital so we will do the bad news first and the good news second today.
Sam's skin was a little irritated under the dressing for his central line after his last admission to the hospital last week. Deb made a mental note for next time to tell them to use his regular dressing instead of the dressing they had been using at the hospital. All weekend he was trying to scratch at his dressing so we knew it was a little irritated. Overnight he had worked his dressing loose and this morning when they went to change it at the hotel they noticed some green fluid around his line. So Sam was back to the ER with a possible infection at his insertion point. Sam was admitted to the hospital today again for observation and antibiotics.
The good news is that the infection is not in Sam's line or even at his insertion point. The irritation under his dressing combined with the warm weather in Wisconsin over the weekend caused his skin to break down around his insertion point. Part of Sam's dressing is a disc called a BioPatch which helps prevent his insertion point from becoming infected. It is a small antimicrobial foam disk that sits on his skin and contains Chlorhexidine Gluconate which is an antiseptic agent. Sam's has a skin infection under his dressing except where the BioPatch sits, which kept the infection away from his insertion point. Some people (doctors) we have talked to didn't really see the necessity of the BioPatch, but I don't think anyone will be winning that argument with us anytime soon. The infection should be no big deal and they will apply a topical antibiotic and gauze under his dressing until he heals.
The other good news is that Sam's direct bilirubin dropped again and he is now at 5.8. Although Deb was a little disappointed, she is anxious to get home so I can't blame her, that represented an entire point, from 6.8 to 5.8 in just six days and really is a huge change. Sam's hepatic liver panel also has improved dramatically and Dr. Puder noticed today that Sam's hands and feet have gone from yellow to pink! All good signs that Sam's liver is recovering and he will get to come home soon.
Sam is still on for his procedure tomorrow to have tubes inserted into his ears. Farewell to the ear infections, we hope they work as well for him as they did for Ryan.