On Monday we met Andrew’s new outpatient cardiologist. He recommended against repeating the transesophageal echo because the findings wouldn't change the trajectory of Andrew’s treatment. We left that appointment feeling good about the plan to stop IV antibiotics and start chemo on Friday. The cardiologist called his oncologist and neurologist, and they all agreed. 

 

Tuesday, we learned that his infectious disease doctor convinced the oncologist and cardiologist that Andrew needed two more weeks of IV antibiotics—but he could still start chemo on Friday as planned. Later we’d hear they extended it to six weeks of antibiotics. The rationale is that a) being on chemotherapy will make it more challenging for his body to fight off a potential infection and b) if he does have infective endocarditis (bacterial infection on his heart), it's still unclear what organism it is and some require six rather than four weeks of treatment. Essentially this is a hedge all doctors are okay with, and no one wants to mess up. His oncologist doesn’t believe antibiotics will hurt the efficacy of chemo.