the eric update – day 12: bugs in the system

sorry to say, i don’t have any substantive news to report today. overall eric appears to be in the early stages of fighting an infection of indeterminate origin, so we got a refresher course in infections and immune response as the staff plays a detective game based on clues from his differential blood count. as i’m sure you all remember from your high school biology classes, there are many different kinds of white blood cells and his doctors are trying to deduce the best therapeutic course based on the available evidence.

why not just “plate out” a sample of cells and see what kinds of bugs are growing? well, therein lies yet another peculiar prematurity problem. the staff can only withdraw a very small sample of blood to test for infections – perhaps a half a cc at a time. this is such a small sample of blood that it’s unlikely in the earliest stages of infection that you’ll actually catch the bugs in the withdrawn sample. in many way, you actually don’t want to find the bug, because then you’ll know that the infection has progressed farther than anyone would like.

so you can’t base your therapeutic course of action on the results of a culture. perhaps you could just blast his system with a wide spectrum antibiotic? that’s no good either, as you’d be creating an environment, what with all the humid oxygen-enriched air that’s being pumped into his system, that would support the quick creation of antibiotic resistant strains of whatever you’re trying to pummel into submission. there are also other generalized bad side effects that result from the administration of prophylactic antibiotics in micropreems.

so you rely of educated guesses after looking at his entire clinical picture. there’s still nothing showing up in his cultures and his total white blood counts are now stabilized, after going on the upswing over the night. more informatively, his neutrophils ( his “big gun” immune cells as wendy, his nurse practitioner, likes to call them ) are down and his bands ( immature neutrophils ) are up. so something is picking off his immune system “heavies” and he’s trying to make more and they aren’t maturing fast enough. his blood sugar is starting to rise slowly, which more specifically indicates that he might have a generalized yeast infection. or at least that’s what they are guessing.

so they’re leaning towards proactively treating him as if he has a yeast infection, but they don’t want to pull out the antibiotic equivalent of a gatlin gun ( technically, it’s called amphoteracin, but all the nurses call it amphoterrible ), because it has nasty side effects that are all the more nastier when you’re born 15 weeks premature. but they did stop his gentamicin which is a general purpose antibiotic and started him on something that i can’t spell because i scribbled it too quickly in my notes and now i can’t read the name. hi. ho. maybe it wasn’t important :-)

and adding insult to injury kris went to the doctor and discovered that while she’s well on her way to making a full recovery, in terms of her blood pressure at least, she has not one, not two, but three different bugs who have started calling her bladder home. of course, there is no single antibiotic that will kill all three, so she has several horse pills that she needs to take several times a day. the doctors don’t appear overly alarmed, “as long as they don’t move to your kidneys.”

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