Osteomyeltis and PICC lines - Mothering Forums
Forum Jump: 
 
Thread Tools
#1 of 19 Old 09-27-2006, 04:33 PM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Daegan (5w old now, born at 30w5d) has developed osteomyelitis (bone infection) in his leg. Once the blood cultures come back negative, they are going to put in a PICC line b/c he's blowing through IVs in less than 24h.

Anyone dealt with osteomyelitis? They told me it's pretty rare in neonates...esp premies...

Anyone have a babe go home with a PICC line? He's doing great in all other ways, no As, Bs, Ds, nippling ad-lib feeds, gaining well....but it sounds like we are looking at 6 more weeks of NICU b/c of IV antibiotics...

Anyone have any info on things I can take to boost the "healing powers" of my breastmilk? I'm not having any supply issues (thankfully) and I'm eating healthy...I just wondered if there was something I could take to make it more "immune boosting."
MicheleVet is offline  
#2 of 19 Old 09-27-2006, 04:43 PM
 
sunflowers's Avatar
 
Join Date: Sep 2006
Posts: 2,140
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Sorry to hear about the infection: I've never heard of it but it sounds pretty serious, I hope he recovers quickly!

My dd blew through IV's sometimes 2-3x per day. She was NPO & on TPN and they had to get a PICC line in asap. Throughout the course of her stay she had 3 PICC lines placed and 2 Broviacs. She was just the type of girl who didn't tolerate lines well. I have heard of babies going home with central lines (not sure if they were PICC or some other type, though) I know the hospital is not quick to send them with one because of the high risk of infection around the line. DD had 2 line infections- 1 PICC and 1 Broviac- and they were pretty serious infections. I wish you Luck and health for your son.

I am interested in the breastmilk question, too. With RSV and Flu season approaching a little extra immunity couldn't hurt us, either
sunflowers is offline  
#3 of 19 Old 09-27-2006, 05:28 PM
 
CallMeMommy's Avatar
 
Join Date: Jun 2005
Location: MN, USA
Posts: 4,318
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Have they said he'd have to stay because of the PICC or are you assuming? My mom has had a PICC before and just had home health come to do the abx, but of course she was a grown woman and not a tiny baby. I hope they let him go home with it, having to stay longer just because of that would suck big time!

Bubba (9) bikenew.gifLukey (5) jog.gif  Fat Baby (2) babyf.gif  Me faint.gif

CallMeMommy is offline  
#4 of 19 Old 09-27-2006, 05:37 PM
 
KatWrangler's Avatar
 
Join Date: Mar 2005
Location: Affton, MO
Posts: 11,191
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My daughter had a PICC put in her neck so we COULD go home. She needed to be on antiobiotics for ten days. They won't keep her if its just for antibiotics. We had Home Health come out every couple of days to check the line and change the dressing.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

KatWrangler is offline  
#5 of 19 Old 09-27-2006, 07:36 PM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
2 line infections- 1 PICC and 1 Broviac
They mentioned Broviacs if the PICC line doesn't work...not looking forward to that...infections in the line are something I'm definitely worried about....especially since his infection is a skin bug anyway (Staph aureus...not MRSA thankfully....but I'm a little worried that could change at any point....) But it's good to hear your daughter went home despite all of it.

Quote:
Have they said he'd have to stay because of the PICC or are you assuming?
They said that "typically the remain in the hospital with a PICC line." The doc didn't completely rule out him coming home with one...but made it sound unlikely...I think they treat neonates differently....but then...

Quote:
My daughter had a PICC put in her neck so we COULD go home.
This is hopeful! Though maybe it will be an option when we have a shorter duration of antibiotics....since we're facing at least 6 weeks of treatment...we might be able to go home for the last 2???

Quote:
having to stay longer just because of that would suck big time!
Right now, we still have a little ways to go before we can say he's staying *just* for antibiotics....there is still a possibility he can't get the PICC line, he could get an abcess in the bone or soft tissues needing surgery, it could become a resistent bug, he could break the bone b/c it's weakened by the infection, the infection could spread through the blood and set up a focus of infection elsewhere....I'm hoping none of these happen of course! The infectious disease specialist thinks we should know more by the end of the week/weekend...his leg should look better/etc...if not we go for another MRI/workup/etc to find out why.
MicheleVet is offline  
#6 of 19 Old 09-27-2006, 07:40 PM
 
KatWrangler's Avatar
 
Join Date: Mar 2005
Location: Affton, MO
Posts: 11,191
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
They had to surgically put the PICC line in my daughter. She did need anethesia.

I will keep my fingers crossed this will mean you can go home soon.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

KatWrangler is offline  
#7 of 19 Old 09-27-2006, 09:06 PM
 
CallMeMommy's Avatar
 
Join Date: Jun 2005
Location: MN, USA
Posts: 4,318
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by KatWrangler View Post
I will keep my fingers crossed this will mean you can go home soon.
Ditto! Keep us posted!

Bubba (9) bikenew.gifLukey (5) jog.gif  Fat Baby (2) babyf.gif  Me faint.gif

CallMeMommy is offline  
#8 of 19 Old 09-27-2006, 11:06 PM
 
srmina's Avatar
 
Join Date: Sep 2004
Location: Chicago
Posts: 428
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My dd had a broviac in the NICU, as well as two umbilical lines. Over the past few months she has had 2 PICCs and now has a Broviac again.

It is very possible to go home with either a PICC or a Broviac. My dd has had one line or another for the past almost three months and has been home with all of them (between her 5 hospital stays...ugh). Home health will teach you how to take care of the line and how to administer whatever she needs (abx, TPN, whatever). Typically, home health does dressing changes and blood draws. My dd has a nurse in the home 8 hours per day usually, but she has a lot of other stuff going on and it is all very longterm or permanent.

If he will only need the line for a short time (less than a month or two), I would go with the PICC because they can usually be placed in Interventional radiology or using an ultrasound. They can even be done bedside at some hospitals. If it is going to be more longterm, go with the Broviac. They usually tunnel them under the skin, which makes the risk of infection much lower. But they do need to be surgically placed. My dd's first Broviac was not tunneled and was surgically placed in the NICU. Her current one is tunneled and was placed in the OR. I find the Broviac much easier to care for and much more convenient...I always had trouble dressing her with her PICCs because I would have to unhook her everytime I needed to change her shirt.

Good luck and feel free to ask any other questions.
srmina is offline  
#9 of 19 Old 09-28-2006, 03:03 PM
 
GatorNNP's Avatar
 
Join Date: May 2004
Posts: 644
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Sorry to hear about your little one's osteo diagnosis. It is uncommon in babies, but preemies are known to get it. I have had a few patients with this and they were successfully treated, even with the infection in the blood. Generally they get long term 6-8 weeks antiibiotic. I had one case with a MRSA and we used vancomycin and rifampin which is unusual. There are complications with PICC lines that may cause your babies doctor to not want to discharge with it in, such as the line migrating into the heart and causing an arrythmia, a hole in the heart or the line escaping the vessel and leakng fluid into the lung linging or chest.

If your NICU doesn't allow parents to stay you could try to get your baby moved to a floor room where parents can stay. As far as boosting your milk for the anti infective properties, use the freshly pumped milk and when possible make sure to put baby to breast even if unable to nurse, some antibodies are produced locally in the breast after being exposed to the baby's microflora. Being in your babies environment helps you make antibodies specific to his needs.
GatorNNP is offline  
#10 of 19 Old 09-29-2006, 12:02 AM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So far his leg is less swollen and the surg/ID/neo all think it's a little better! Taking small miracles when I can! He's on nafcillin and rifampin...and the current blood/CSF/urine cultures are all negative so far....plan is a PICC line on Sunday and a repeat MRI next week.

Quote:
I have had a few patients with this and they were successfully treated, even with the infection in the blood.
That's what I needed to hear!!

GatorNNP...is that for UF? My husband is a 2006 med school grad and I am a 2005 vet grad...this is from 2 weeks ago...learning the bottle

I've been working on breast feeding...he nursed for 10 minutes today! And I have been giving him fresh milk...good!
MicheleVet is offline  
#11 of 19 Old 09-29-2006, 12:23 AM
 
mommyto3girls's Avatar
 
Join Date: May 2005
Location: Ohio
Posts: 2,041
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
(((Michelle)))

I am an adult so totally different, but I had a PICC line for 6 months while I was pregnant with Sage. I was on TPN 12 hours on, 12 off whenever I could be home (I was in the hospital 90 days on and off) I also was on IV Zocyn (antibiotic I took for a perforated bowel) 4 times a day. I hooked it all myself. I had a HHN that came out twice a week to clean the line and do blood work.

They were really surprised that my PICC lasted as long as it did. Every visit they questioned if it would be the last one before it was replaced. I have had PICC's placed for 2 short hospital stays since then. It hurts goign in, but I blow IV's about every 6 hours so much less painful than that!
mommyto3girls is offline  
#12 of 19 Old 10-04-2006, 12:16 PM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
They've been unable to get a PICC line in him...we're looking at surgery for a Broviac this week. I've mixed feelings...I'm nervous about surgery/anesthesia/bleeding...but I really like and trust the peds surgeon and they can draw blood from the Broviac for follow up labs....meaning less sticks for my little one. He's feeling better on the leg though! And he's eating like a champ and gaining almost 2 ounces every day. He's getting soo big and chubby!
MicheleVet is offline  
#13 of 19 Old 10-04-2006, 01:44 PM
 
KatWrangler's Avatar
 
Join Date: Mar 2005
Location: Affton, MO
Posts: 11,191
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Mama! They didn't try to surgically put the line in? They surgically put the line in my daughters neck.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

KatWrangler is offline  
#14 of 19 Old 10-05-2006, 12:53 AM
 
srmina's Avatar
 
Join Date: Sep 2004
Location: Chicago
Posts: 428
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yup, nobody could get a PICC in my dd when she was a baby either. If you have to have it placed surgically, go with the Broviac over the PICC. It is literally a 15 minute surgery and there is virtually no bleeding at all. Keep us updated.
srmina is offline  
#15 of 19 Old 10-05-2006, 11:39 AM
 
CallMeMommy's Avatar
 
Join Date: Jun 2005
Location: MN, USA
Posts: 4,318
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
WTG on the weight gain, that's awesome!

Bubba (9) bikenew.gifLukey (5) jog.gif  Fat Baby (2) babyf.gif  Me faint.gif

CallMeMommy is offline  
#16 of 19 Old 10-05-2006, 09:49 PM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Got the Broviac today...(it's a surgical line placed in the neck/chest KatWrangler) So far so good. ***keeping our fingers crossed that this decreases our hospital stay***
MicheleVet is offline  
#17 of 19 Old 10-07-2006, 05:59 PM
 
KatWrangler's Avatar
 
Join Date: Mar 2005
Location: Affton, MO
Posts: 11,191
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
How are you doing?

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

KatWrangler is offline  
#18 of 19 Old 10-08-2006, 06:10 PM - Thread Starter
 
MicheleVet's Avatar
 
Join Date: Dec 2005
Location: Florida
Posts: 185
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
How are you doing?
I'm not suicidal and I'm not homicidal...other than that? We've got some docs telling us he should be home with us...and some that are more reluctant to let him leave. It's very frustrating....the "good" is that one of the pro-home docs is the chairman of pediatrics...meaning he's the boss of the NICU....the "bad" is that one of the pro-stay docs is the neonatologist...ie the guy with the most premie experience. I think though that the "lean" right now is towards sending him home...I just hate to get my hopes up, ya know? But really I don't have anything else to look forward too...he's taking the bottle really well...hasn't had any A's or B's since recovering from anesthesia...he's 6.5 pounds and keeping his temp well....his leg seems better (still swollen and a little painful at the hip, but much improved!). We're slowly working on nursing at the breast. He latches well if he's awake, and the other day he nursed for 25 minutes before falling asleep...but I'm not sure he's getting enough....once we're home I'm going to try to move more to the breast and then monitor weight gain....but now in the NICU I don't want anything to keep him from coming home....I think he'd prefer nursing more often than their every 3 hours schedule...but I've been such a pain about everything else there that I don't want to make even more waves...and I don't want to be at the NICU every two hours to nurse him/feed him....I just can't do that right now. I know he's getting milk when he nurses....he always has a mouthfull when he comes off the nipple...I guess it's just a natural fear/worry of moms... DH and I are finishing getting everything ready around the house incase they tell us this week is the week. My mom is coming to visit next week so it'd be great if Daegan could come home then...I'm keeping the "discussions" secret from my mom just incase...cause it'd be an awesome surprise...but it would really bum her out if it didn't turn out. I've packed a bag just in case...that way I don't have to later...and I'm going to install the carseat base...I washed the carseat covers already.

I'm feeling worn out from the emotional ride...I have a hard time at night...

"just keep swimming, just keep swimming"
MicheleVet is offline  
#19 of 19 Old 10-08-2006, 06:33 PM
 
ksera05's Avatar
 
Join Date: Apr 2006
Location: TN
Posts: 8,342
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by MicheleVet View Post
I'm feeling worn out from the emotional ride...I have a hard time at night...

"just keep swimming, just keep swimming"


Right there with you, down to the sleeping part. I hope he gets to come home soon. Really, really soon.

-sarah-
mom to three, 4 and under.
ksera05 is offline  
Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off