Yesterday, Garrett’s right arm and hand began to swell below his central line and there is a significant difference in size between the right and left side. I asked for an ultrasound. The ultrasound was very painful for Garrett. The sores on his body hurt to touch and he has quite a lot of large ones where the ultrasound probe had to be pressed. He screamed through most of the ultrasound prolonging the process. Garrett does have a small clot, but it is not fully occluded. Typically, an anticoagulant would be started, but in a post-op IBD patient, the protocol is not as straightforward. Hematology and surgery are meeting this morning to determine next steps. They want to save the central line in order to provide nutrition for Garrett, but need to determine the best course of action. In the interim, he is on pain medicine for his arm (in addition to his abdomen and skin) as the swelling in his hand has now become significant and very painful. He can’t close his hand without crying.
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