So last I posted Ananya had a fever which was a little bit of a bummer. She got started on some heavy duty antibiotics given her recent surgery and immunosuppression, and risk factors like being on the ventilator for 3.5 days. Interestingly the v. early infections after transplant are probably not related to being immunosuppressed - typically those bugs are bigger players later in the game - I assume b/c it takes some time to whack down your immune system. I was a little peeved Ananya still had her foley catheter (bladder catheter) still in. All these lines and tubes going into the body are great sources of infection - so the sooner those can come out safely the better. The foley had really outlived its usefulness...and I had asked the day before and got some bulls*&*t answer from the nurse about monitoring output. Its surprising to see (now that I'm on the other side) how much the nurses act as gatekeepers of information. There is constant censoring of information going on between the nurses and doctors - the nurses v. much shade their presentations of the patients. Anyway, nurses are probably the most important part of the healthcare team - but if you don't like the answer you're getting from a RN - don't be afraid to kick it up the doctor - just do it in a way that avoids upsetting the nurse..
So I asked about the foley catheter this morning when the transplant team was rounding and they were similarly excited to get the foley out. I also came to find out that Ananya's nurse for the day also was taking care of another post liver transplant kid next door. Which ordinarily would be fine - except this particular poor kid was growing out some super resistant bacteria. I let the team know that I was not happy about the nursing assigments - they said they'd see what they could do but emphasized to the nurse in the meantime about gloves/gowns/hygiene. So by evening shift the assignments had changed, but a last minute switch by the RNs again left us with a nurse covering Ananya and the kid with super resistant bugs. That soured my mood quite a bit. If Ananya does get the same super resistant bug that the other kid has - I may have a cow. One thing is always painfully clear - no one cares more about the welfare of your loved one than you. Seems simple but I think there's a sense when you go to a hospital the caregivers do everything they can. The sad truth is that for the large part of the team - you represent a job...folks will do the best they can - as long as they're not too inconvenienced. So our RN will work her tail off - but the system fails her. you could blame the charge nurse, but she's probably leaned on by administration to optimize patient-nurse rations - so in the end its always the suits/money counters who are to blame. Health care is simply not an industry that does well when the bottom line is the bottom line.
Ok, ok, enough editorializing. Ananya's fever responds to tylenol - it seemed to break early this am - without tylenol. hopefully it stays down. Maybe its due to tat collapsed right upper lobe that we need to open up with some good chest physical therapy...Otherwise liver numbers look good, ultrasounds i'm told of the liver look good as well. which makes me happy despite the little day to day frustrations.