Infection After G-Tube Closure

posted in: Apollo | 18

This is part two. You can read the first post Infection After G-Tube Closure here.

Options were discussed for sedation. I told the doctors that after safety, my next priority as comfort. Whatever they did, they needed to make him comfortable. They decided on Ketamine.

The doctor told us we could stay and be present for the procedure or leave the room. I didn’t even need to look at Chuck or ask what he thought. Of course, we wanted to stay. 

As it was explained to us, Ketamine is a sedative that makes the patient unaware, is an anesthetic and the patient will have no memory of the procedure. Sounds perfect, right? The anesthesiologist told us Apollo’s eyes would start to shake back and forth, but not to worry because that just told her the medicine was working. What wasn’t explained to us or what I didn’t fully understand at the time, was that his eyes would be open the entire time. 

But let me back up. 

Complications after a g-tube removal. Apollo got a surgical infection after his g-tube removal.

The doctor wanted Apollo to have Zofran before the Ketamine to combat nausea. In came a nurse with a dissolvable tablet that she wanted to place on his tongue.  He was sick, feverish and on morphine. By now it was past 1 AM and Apollo was sleeping. The nurse asked us to wake him and put the pill on his tongue. It took several minutes to get him awake.  When she finally got the pill on his tongue he spit it out and clamped his teeth down. At this point, she said, “Hmm…let me see if I can just put liquid Zofran in his IV“. 

Gee, I wonder. I see my birth clients get Zofran in their IVs all. the. time.

Eventually, liquid Zofran was found and administered.

A team of seven doctors and nurses assembled (all in yellow precaution gowns ) for the procedure. There was the surgeon who did the original surgery, the doctor who did the procedure, an anesthesiologist, a resident and three nurses. It was one of those moments when you wonder whether it’s a great thing that 7 people are caring for your son on a very busy night in the ER..or something you should be concerned about. 

Equipment was wheeled in and Apollo was given the first dose of Ketamine. His eyes opened (he had been asleep up until this point) and he began to look around. The doctor began swabbing his stomach with disinfectant and he brushed her hands away. Umm…isn’t he supposed to be more or less unconscious? The doctor waited another minute or two and then tried again. This time he didn’t flinch. After swabbing the area the doctor peeled off the glue over the incision.

Next up was a scalpel, inserted into the stomach of my son who was looking around the room. The doctor reminded us, “I’m not cutting his stomach, I’m just cutting the stitches”. Except we all know that after four days of being stitched and glued together the skin was indeed being cut.

As soon as the layers of skin were cut, thick yellow pus bubbled up from the incision. The doctor inserted a tong-like instrument and opened the wound more. Now the pus, tinged with streaks of blood, poured out. So much for it being “too soon” to have developed an infection. 

Chuck and I are not squeamish at all. But watching your son, eyes open and roaming the room, be cut open and seeing pools of pus ooze out of his six-year-old belly? That’s a lot for a parent to take in. My eyes traced a path between Apollo’s face, Apollo’s stomach, the doctor doing the procedure and the anesthesiologist. At this point Apollo started up with a groaning that sounded like a scene from the exorcist. 

As the doctor began pouring sterile water into Apollo’s abdomen to clean it out Apollo began saying, “Mama, mama, mama…” which faded into, “ma…ma…mm….mmmmmmm”. It was downright creepy. And heartwrenching. 

Every few minutes the anesthesiologist gave Apollo another dose of Ketamine, speaking her actions out loud so a nurse could record the time. The doctor, deciding the area was clean enough, packed his tiny belly with gauze, leaving an inch long strip hanging out. At this point  Apollo started saying, “go  home…go home…home…home…home…” which convinced me he was indeed aware that something unpleasant was taking place in his body. If you wonder why I look old and haggard these days, this is one reason why. 

The doctor explained they were now going to leave the wound open with the wick of gauze hanging out. They want air to be able to get into the wound to discourage the growth of bacteria. Then she explained that I would need to pull the gauze out on Tuesday. Yes, there is at least a foot of thing gauze in his open surgical site…and I have the pleasure of pulling it out. 

We really know how to have a good time around here, my friends.

Apollo's wound was left open to lessen the chance of infection at the g-tube closure site.

Apollo was bandaged up and he began to stir. He reached up, attempting to pull the nasal cannula out of his nose. The anesthesiologist laughed and said, “If you can pull that out  you are aware enough to not need it!” True to form the boy woke up fast. 

“Mama? Mama!” were of course his first words. 

“I’m right here,” I said, moving right above him so he could see my face. 

“You have three eyes!” he exclaimed.

“Are they pretty?” I asked.

He paused for a moment and said yes.

He was high as a kite, trying to talk, not making a lot of sense. Apparently, Chuck had four noses “because two plus two is four”

Apollo was full of psychedelic wisdom.

As Apollo took a trip upon the magic swirling ship, the doctors gave us the run down.

Antibiotics prescribed for infection after g-tube closure.

The gauze needs to be removed on Tuesday. 

Apollo needs to been seen in clinic (in Seattle) later this week to check the healing process.

Apollo needs to  take an oral antibiotic for ten days. 

And a probiotic.

Remember when I said one of my biggest worries was Apollo needing to take pain medicine after his surgery? Because in the all of the progress we have made in the last four years, teaching Apollo to eat, liquid medicines are one of his most difficult challenges? It looks like we are going to face that giant right out of the gates. He now has five bottles of antibiotic that he needs to take in the next ten days.

Half a bottle a day.

In addition? Now that he has had an infection at the g-tube closure site, there is a “significant risk” that he will develop a stomach fistula.

That is, a hole in his stomach.

That will need to be surgically closed.

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18 Responses

  1. Lord have mercy. Poor Apollo. And you and Chuck! Prayers that healing is speedy and complete with no further complications.

  2. I don’t know your stance on naughty word usage but I used quite a few of them in my head on your behalf as I read that. I am so, so sorry Renee. I get this more than I would like to. I hope this is a grand finale in Apollo’s saga of medical freakyness. (spoken as the mother of a much beloved medical freak and mutant <3 )

  3. Oh good grief, after part one I had hoped that the worst was over. Part two was just as bad…. If it is any consolation, after staph infection in the incision following an appendectomy, I had a wide open incision left to close on its own, with lots of “maybes”. But it healed fine and nothing more happened. Lets hope Apollo and all of you can catch a break!!!

  4. Cecily.spencer24@gmail.com

    I was wondering if you would mind if I in addition to praying put Apollo and your family on our temple prayer roll?

  5. I thought Seattle children’s was supposed to be one of the best. Your many experiences leave me feeling they’re possibly just an over rated clown school
    I’m so sorry these things keep happening to him.
    You’ll have to tell any future doctors that if there’s a rare chance, that’s what he has.
    I have to tell my drs the same. I’m all about breaking the mold.

  6. My husband had to have a packing like this, his wound was much smaller but he said it felt like someone pulling all of his insides out. He refused to let me help remove it (initially he wanted me to try yanking on it very hard to just get it out all at once, highly recommend against that). He said it was much less painful if he very very slowly pulled it out himself. (As in 1-2 hours). Not sure if that will be an option for apollo or not and so sorry that he had to have this done.

  7. Many years ago my daughter Katie had a port infection. They had to leave the wound open to drain after removal of the port. The surgical resident came in to show me how to pack the wound. That had such an innocent sound to it. What “pack the wound” meant was taking a wooden stick with a tiny piece of cotton on the end and using it to jam a foot of gauze into a wound about an inch and a half wide. As he showed me how to do this he explained, “mom, this needs to be done once a day for the next 5 to 7 days”. What I heard is “mom, you must impale your daughter’s wound with this stick and jam a t-shirt worth of cotton into it while she is thrashing about and wailing like a banshee or she WILL DIE AND IT WILL BE YOUR FAULT”. And good times were had by all…NOT! Praying things go smoothly from here on out.

  8. this is so sad. praying for God to heal him PERFECTLY!! Praising God for giving Apollo great caring parents.

  9. Oh this is SO NOT FAIR!!! My heart goes out to you and Apollo. Praying for him – for healing, and for taking all that medicine. Ugh!
    Amen to what Vivian said… I’m so thankful Apollo has YOU 😀

    Julie

  10. oh my word. I know it’s a MUCH longer drive but maybe you should drive down to Portland’s children hospital. it is MUCH better, having had a kid there myself. I think it is amazing how you have patience to not be mean and rude because I would be. 🙂

  11. Oh, my. And that is one strong antibiotic, I can tell you. I don’t know hospitals in your area, but the doc’s idea that it was “too soon” for some infection to develop struck me as crackpot–I had a similar situation with one of my kids. I KNEW THE KID WAS SICK! Doc said no. If you have any doubts, hope you’ll get a different, better doc. And eventually, some sleep! My sympathies!

  12. Oh Good Lord!!! I hope it all heals nicely and he doesn’t have to go through this again!

  13. Long time lurker and reader here (since before Apollo was born!). I am a pharmacist and I feel so terrible that your first round of oral antibiotics is liquid clindamycin– it is the WORST smelling and tasting of all of them- poor Apollo!! In case no one at the hospital told you this trick- mixing each dose with chocolate syrup can make it much easier to take. Clindamycin isn’t an antibiotic that will bind to calcium, so it is a-ok to do this! Not much else will mask that nasty taste. I’m hoping you guys get through this as easily as possible!!

  14. Oh, poor Apollo! I was really really hoping this time would be uneventful, though I can’t say I’m surprised.

    Sometimes I wonder about these “top rated” hospitals. I used to work at Cinci Children’s and it was not a pleasant experience. What I saw behind the scenes made me think they just have some really good PR people and spend a lot of money on that.

    Some nurse gave me 3x the high dose of Benadryl when I was about to deliver twins. We were all okay, but people need to pay more attention that. It is, after all, their job…

  15. Praying for healing and that he will take the medicine. And for encouragement, comfort, strength and energy for you and Chuck!

  16. Oh, Renee. My heart just aches for you and your husband, who will remember this long after Apollo forgets it. I hope you get some time to have a good cry or boxing session or whatever else might be cathartic for you. I am sending you whatever leftover strength I can. Hang in there.

  17. The newest post says it’s a broken link I can’t read it

  18. I can’t get the link on your 24nov post to open.

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