Trying to Find the Infection

 9 AM Thursday (now that I realize this is more of a morning and evening newspaper, not just a daily)

Jon was admitted back into the hospital, about 30 hours after he was discharged. Much nicer room with a window.  He has an infection somewhere and they are trying to find it.  His fever is not scary high (somewhere around 38.3 was what got him back there), but it is a symptom that has been coming and going for about a week.  They did another work-up, he told his history to a new doctor (who may be a third year resident like Alissa, she seems familiar that way) and the doctor ordered a bunch of tests, seeking information. They can just roll all these machines right into the room. It's a huge room with plenty of space and comfortable places for others to sit.

When I left last night at 11, the doctor was holding off on changing his antibiotics while she tried to figure this out. She said that the labs were showing that his levels of vancomycin were not yet "therapeutic" which means that the antibiotic hadn't even had a chance to try to fix the staph problem.  She said she could change her mind about that in a heartbeat, if his temperature went up. She said she was not so sure it was the central line that was causing the trouble because the blood cultures weren't really showing a consistent story and there isn't any pain or redness or other indicators. Like Alissa said, she said that this is a very standard hospital admission -- a fever that is unexplained in a patient who is about to have a bone marrow transplant...they really want to find this and fix it before they give him the next big dose of chemotherapy.

Jon reports that at 4 AM today they found his oxygen levels were very low so they put him on oxygen. He hates this ("this is unacceptable"). But now they are looking harder at pneumonia as a possible source of infection. He has developed a cough recently, and the last time he was so low on oxygen, it did turn out to be pneumonia, so this sounds quite possible. And I have been noticing, and reporting, that he is breathing faster when he sleeps. Since he hasn't been trying to walk or work, it is hard to tell how short of breath he really is. They are starting new antibiotics that are for pneumonia, just in case.

There will be a whole new team learning about his situation this morning. Jon was seen by his PA already who said that the issue of taking the line out is still in question. She asked Jon what he thought about it (this is so important -- he hates it when he is not informed and consulted). After some thought, he said that the line they put in his arm last night, since they are now avoiding the central line until further notice, is not working well. It hurts and it just doesn't work that well. While he hates this big thing coming out of his chest, it works.  So if they end up deciding that the central line is not the source of infection, he reluctantly thinks he would rather have it than something else. They will make the decision, of course, but at least they asked him what he thinks.

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