Plan

Warning nothing in this plan is very new...

Dr. M and Dr. V spoke. The plan is to get her started on 14 days of an antibiotic, the same one we used for the VRE before. After 2 days of the abx they want us to do bladder irrigations with acedic acid. Just imagine folks, sticking a catheter up your you know where and pushing an acid up into your bladder.. yep she's not too thrilled. We've done this before and it was rather painful. We don't have the specifics on the volumes or frequency yet. The idea here is to keep that mucous broken up so it can flow out of the bladder easily.

I'll be honest, this sounds as pointless as just treating with abx. After the last round we mechanically cleaned out the bladder and still got reinfected so why will this be any different.

I spoke to Dr. V a bit this afternoon. He said that enterococcus (the E in VRE) is a perfectly fine bacteria to have in your bowel, just not in your bladder. Katie probably transferred eterococcus to her bladder before the transplant and was able to kill it off with her natural immune system, but now that she's immunosuppressed she can't do that.

Her Prograf dose came down today so maybe that will help her fight these infections.

Please keep us in prayer. Katie is very upset about the acedic acid irrigations, and she had some side effects from the tigecycline before that will likely cause her to miss school and more importantly dance.