Today's news was not very good. The TEE was OK, valves seem to be doing OK, they couldn't visualize the aortic well, but the function is OK. This afternoon's news was disturbing. Joe's cultures have grown a bacterial infection. The consensus of opinion is that his pacemaker might be infected and possibly spun off some clots causing the spleen infarctions.
The other news is that he is allergic to the most important antibiotics they can use for this infection. And they all can cause kidney problems which is something that Joe cannot have.
The Infectious disease doctor didn't mince any words, he was worried, and not only about the pacemaker but the valves. I don't think he felt they were out of danger. And he suggested that removal of the pacemaker is possible, and said that they are not easy to remove. I guess the leads would have to come out as well.
By the way, the pacemaker is a Guidant. It wasn't on the recall list the last time I looked. But there were recalls for infections in Guidant pacemakers.
His temp was a little lower today but still there. He is still having episodes of stomach and intestinal problems. But that may be from the Lactulose. However he has to have that and enough of it to produce at least 3 evacs. per day, in order to clear the ammonia from his system.
About the only good news is that the flank pain from the infarctions in the spleen has gone away, so I guess the inflammation has lessened, leaving just the necrotic tissue.
So, it's a mess. He has been started on some antibiotic he can have, and tomorrow, there may be a better game plan. It's a serious issue. Things can sure turn on a dime---