Surgery update, still admitted.

The surgery last week ended up being more extensive than originally expected. The muscle had deteriorated to the point that the bone was essentially exposed. Because of that, they had to remove a few centimeters from the end of the bone, repair and restitch the muscle, and place a wound vac to help with healing.

As a result, Allison is back in the ace wrap and knee brace full-time for a week, much like she was after her original amputation. She can remove the brace briefly to give her skin a break, but she is not allowed to bend her knee at all during this time.

Pain control was very challenging during the first few days after surgery and continues to be a struggle. Her CRP (marker of inflammation and infection) increased after surgery and has continued to slowly climb, while her ANC (marker of her immune system function) has once again been dropping. One doctor called the continued rise in her CRP "puzzling." Because of her lab results and difficulty controlling her pain, the team decided to delay chemotherapy for several more days. Again.

Today, they finally decided we could move forward with chemo, although her numbers still aren't where anyone would like them to be. They also had to change one of her antibiotics because it wasn't compatible with the chemotherapy. Infectious Disease said this may be good timing for the change too, so we're waiting to see whether that has any impact on her CRP. I'm also hoping that the chemotherapy itself doesn't end up prolonging her recovery from this infection.

They repeated a CT scan yesterday to check on her lungs and monitor the infection there. The team had also wanted to do an MRI to follow up on the spot they found on her liver, but because she currently has the wound vac in place, that imaging will need to wait until the wound vac is removed on Thursday. The CT showed encouraging improvement in her lungs, although they said it wouldn’t be surprising to continue to see signs of infection for months. She is still requiring extra oxygen at times, but starting to improve there as well. The liver finding appears unchanged. They did identify a new spot on her spleen that they want to keep an eye on, but for now they don’t seem too worried because she doesn’t have a fever or any other signs of the infection spreading, other than the CRP increasing. 

I feel a little like a broken record every time I say we're hoping she'll be home in a few more days, but that's just the reality of this process. So once again, we are hopeful she'll be home in a few more days! The plan for this week is chemo, then to remove the wound vac on Thursday, and possibly complete the MRI on Thursday or Friday. Before she can go home, she'll need to clear this round of chemo, her doctors will likely want to see some improvement in her CRP, we'll need a solid antibiotic plan for home, and her pain will need to be controlled with oral medications, which it isn't quite yet.

As always, we are so grateful for the continued prayers, encouragement, and support. Thank you for continuing to walk alongside us through all of this.