10:00 AM: Sophie seems to be feeling better today. Her last fever was at about 11:30 last night, so we're pleased it hasn't crept back up yet. She's off the heart monitor today (it had been really high when she had fevers but seems to be mostly normal now), and they reduced the fluid rate on her IV during the night (I was getting tired of taking her to the potty every half hour!). Unfortunately, her ANC (the blood count that shows risk of infection), which was heading up (.7 yesterday) was .3 this morning. They definitely won't let her go home if it's below .5, even if she seems to be responding well and the latest blood culture doesn't grow anything. This ANC level also means she has to wear a mask when she's out in the hallway, and she's not crazy about that.
They still haven't gotten an official identification of the staph bacteria, but given that she seems to be responding, they are sure they're on the right track. He also said they tested the levels of antibiotic in her system just prior to a recent dose (partly to make sure the levels aren't too high--which can cause deafness), and it turned out that her levels were low. They want the level to be perfect before they release her, so that--in combination with the lower ANC--probably means we're looking at being released on Thursday at the earliest. Bummer. He said he is worried that because she only had one or two doses of the vancomycin in her system before they did yesterday's blood culture, he's going to order another one today as a backup. It would be very disappointing to be headed for release and have something grow in yesterday's culture tomorrow. A culture taken today would run for 48 hours and would still allow us to release on Thursday if it's clear. If they wait and take a new one tomorrow, we would have to wait 48 hours until Friday. Of course, it's still possible that the treatment will ultimately be so complicated that they decide to keep her here to administer the full 2 weeks of IV antibiotics.
I feel incredibly lucky to have with us today a student nurse from UNC, who is assigned just to Sophie. In addition to taking her vital signs and helping administer medicine, she's just hanging out with Sophie, and playing, and laughing, and they are having a great time. She'll be here until 2:00 today, so when Randall gets here, we're going to go out to lunch together somewhere. I'm really looking forward to that. Then sometime this afternoon I'll head home for the first time since Sunday afternoon and sleep in my own bed.