Hurricane Ian with a side of Sepsis

 Here’s a little backstory: Khadees has needed a PICC, which is a peripherally inserted central line (basically a line that goes to his heart) for the continuous infusion of Milrinione that he needs.  For the last 6ish weeks, we’ve been trying to figure out what he is allergic to.  For a central line, the dressing needs to be changed once a week, usually using chlorhexidine (CHG) to scrub the line.  Once the CHG dries, a biodisc with CGH is placed directly over the line insertion site and then a tegaderm is placed over to keep everything in place.  Not knowing whether he was allergic to the CHG or the tegaderm, they started using a hypoallergenic tegaderm and betadine to scrub instead of CHG.  

2 weeks after the first PICC was placed, he had severe allergic reactions, causing boils and blisters beneath the dressing.  However, up until Monday, the biodisk was still used.  This Monday, the redness and irritation was specifically under the biodisc, so the decision was made to not use the disc.  He previously had the line removed and a new one placed because of the severity of the allergic reaction.  (To spare everyone out there, I will not include the pictures.  I’m an RN and still found them disgusting).  

As mentioned previously, Khadees has continued to have more and more symptoms of his heart failing.  On Tuesday, he just felt awful.  He decided to call the Heart Transplant Team since he was becoming nervous.  They asked him to come in through the ED to get checked out, specifically concerned for sepsis and worsening heart failure.  

Of course the night before the hurricane, the hospital was busy and the ED was holding patients instead of having places to admit and send upstairs.  He was admitted quickly, but held in the ED.  When Advanced Heart Failure rounded in the morning, we were still in the ED.  His WBC and lactic acid were all within normal limits.  His CRP was mildly elevated, which indicates any inflammation, so just the irritation at his site could trigger this.  Blood cultures were drawn, one from his PICC and another from a separate site.  His PICC was pulled and sent for culture and a peripheral IV placed.  With the storm coming, and Khadees nervous and desperate to be at home, and labs looking okay, they gave the okay to be discharged with the understanding that he would have to return if the cultures were somehow positive.  They also would schedule a heart cath to look into the worsening conditions he has been experiencing.  A few of his meds were adjusted, and he was discharged home to ride out the storm.

Hurricane Ian gave us a crazy run.  However, I know what we experienced is nothing compared to many of our friends in South Florida, and our prayers are with them. Here, we did not lose power (shockingly).  However, we did experience some flooding in our downstairs bedroom, as we had flooding on the side of our house and it was seeping in through the bottom.  With a shopvac, we worked to remove the water.  This is the only room downstairs that has carpet, so a lot of the water was soaked through the carpet.  It did not spread past that room, but we will have to look into how to fix the foundation and bedroom.

Parts of our fence are scattered across our yard.  Our pool luckily drained into the yard as it overflowed.  We somehow didn’t lose power, so that’s a win.  Both Kellan and Stella slept through the majority of the eye passing us at night (yay Melatonin!) but Allie was terrified.  I spent most of the night up with her, trying to keep her calm.  She would constantly ask me, “What’s that?” every time she heard a noise.  “It is just wind.”  I would tell her, and each time she responded, “I don’t like it!”  Me neither, sweet baby.  She was only okay if I was holding her, as she just didn’t understand what was happening.  

During the hurricane, we got a call from the ED saying Khadees’s blood cultures were positive and he needed to return to the ED now.  Positive blood cultures indicate he has a systemic infection, which is very dangerous and needs to be treated as soon as possible. At this time, the eye was set to go over us within an hour or so, and there was no way to safely drive to the hospital.  After talking to the Transplant Team, they told us to wait it out and we would do a direct admit as soon as the roads were safe.

The next day, we got another call for the ED, he was positive for two separate bacteria and still needed to return ASAP.  Now, the roads had turned into rivers, as people kayaked through the streets.  Khadees’s vitals have remained stable, he’s been afebrile, and currently shows no sign of septic shock.  So, the plan is to directly admit tomorrow morning, as we pray the roads get better overnight.  

While Khadees is fighting an infection, he is considered Status 7, which means he is inactive on the Transplant List. He will not be able to receive a transplant while he has any sort of illness or infection. So, if it takes 10 days for the infection to go away, that is 10 days he is unable to receive a heart. In addition, infections (particularly systemic infections) can cause extra workload to the heart. Every bit of this is scary.

On top of all of this, my mom leaves Saturday and Khadees’s mom takes over as our super helper.  I know they say God doesn’t give you more than you can handle, but He is really trying me.  I am trying my best to focus on one thing at a time, specifically the things I can control.  So for now, I’m thankful that we are all safe after Hurricane Ian, and that Khadees continues to remain stable and will hopefully be safely admitted tomorrow morning. 

(Pic of our youngest hurricane ride-out partner!)