More UTI Related Issues

After the ecoli findings over the weekend and the medicine in the system things seemed to be working well. Elias was no longer throwing up and feeling miserable. On Tuesday night however, things got a little concerning. We noticed that there seemed to be what looked like brick red color blood in Elias colostomy bag. This would potentially mean blood in the stool. We called the BMT on call to advise given the complexity of the fistula connection causing the UTIs and this ecoli, along with the medicine, etc. At first we were told to come in the ER, thankfully that was avoided as the doctor was investigating the medicine Elias was ordered.  Apparently this medicine has a tendency to change the color of the stool to give the appearance of blood. As long as Elias was not vomiting, lethargic or spiking fevers we were okay to stay put for the evening. When Elias FA doctor got the report this morning we were promptly called and told to come into the clinic today! Dr. Mehta wanted to have all kinds of stool labs done as well as blood work. They were concerned about his counts, which those words have never come out of their mouths in relation to Elias. This had us a bit concerned given the urgency they were creating about him coming in.  It is a little complicated and I’m not sure I even fully understand it. We are still waiting on a few more lab results, some will be back tomorrow, some on Friday. Here is what we know and were told.

• 1.There is apparently blood in his stools
• 2. It is possible the strong antibiotic caused it (see below)
• 3. Potentially the C-diff negative we had a week or so ago could have been a false negative
• 4. The C-diff has returned potentially and the spores can cause irritation and rawness internally
• 5. If that is the case the strong antibiotic could then induce bleeding
• 6. Thankfully Elias platelets looked good as did the hemoglobin #s  
• 7. We are stopping the strong antibiotic and going back to a stronger dosing of the prophylaxis.
• 8. We will resume Flagyl, the medication for C-diff for an indefinite course to help discourage more issues
• 9. We will more than likely be called back in after all the results are in.

Elias was given a vitamin K shot and probiotics were discussed. It is possible the elecare formula he is on currently could need supplementing to help with nutrients the body needs for natural bacteria defense. This may finally force someone to really address his nutrition needs which is something we have been working to achieve. They also are checking the coagulation levels for his blood. Most of what they were testing did not have clear reasons on the surface, but we know the FA team knows what they are doing. I am sure they will go into more detail why they did each of the test and what they were looking for tomorrow when we talk on the phone.  Elias is doing well despite the odd scenario. I think he has just started to become accustom to feeling crumby with the UTIs and he just works through it.  As bizarre as this all was, I think the radar for concern is diminished. At least for anything really serious. The labs will paint a clearer picture.

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