To Boston and back yet again

Dr. Jennings has been great about looking over emailed photos of Peter's wounds the last few weeks, and ultimately felt it was time to surgically fix them.  Peter had retained some of the sutures from his surgery in September instead of them dissolving, and the skin around them had some localized infection surrounding the retained sutures.  Some of those sutures had come out on their own, but the rest needed some assistance, as they were painful and not healing.  Peter did well with the brief surgery, but it took him five hours after the surgery to wake up!  The wound cultures are growing out a Staph Aureus species, so it looks like Peter will need to begin a course of antibiotics, which in Peter's case is not always such a simple thing.  Ideally he would be given enteral antibiotics, but of the four antibiotics Peter has had reactions with, three of them have been administered enterally.  He has done OK with two of those three in IV form though.  So, we are waiting to see what the dosing will be and hope that it will be a schedule that is not too crazy to keep up with. 

Peter is now up to 1000mL of formula per day and there is talk of taking him completely off TPN in the next week or few and just giving him some IV fluid for hydration on the nights he would have needed TPN.  From there it should be a pretty fast switch to IV fluids just as needed, I think.  Hopefully Peter will not have any side effects from the antibiotics and will continue to make these great strides in getting off TPN.  We are reluctant to take him off TPN from the standpoint that he will no longer be on Omegaven, but if he gets off TPN his liver should get healthier and his appetite should increase.  He has been on TPN since Spring 2006 and on Omegaven since late December 2007.  It is exciting a few nights off TPN each week; I can hardly imagine NO TPN.  I'll post when it becomes official.