A very frustrating day. The good things of the day were that Tim was feeling ok this morning and we (Tim's wife Angie, Beckie to drive and I) left Soroti at 6am.  Travel went very smoothly, putting us in Kampal in a fast 5 hours. We were able to get right in and be seen. But that is about where the positives seemed to end. The British doc didn't take us seriously at all. He talked of bursitis or gout. I told him again and again of the past few days and he responded Tim is a young guy so his low blood pressures are normal, fever is no big deal and pain is to be expected. He even went so far as to say I shouldn't have given the big antibiotics. He tried twice to do a needle aspiration and got nothing. Then sent us to ultrasound where they could see a big pocket of fluid but not in the joint, above it. (I would have sworn that the fluid drawn off in Soroti was from within the joint not above it but I have no proof).  He did culture the fluids- positive for pus but no organisms seen. So he sent us home (to the guest house) and said we could come back at 2pm the next day to make sure the fluid pocket hadn't reformed.  When pressed about abx he said Tim could stay on the Levaquin but all he needed was PO. So, tired and discouraged but trying to be happy that at least Tim wasn't so sick we headed out to find something to eat.  (I want clarify this point- Tim is better as we left but still not great.  Limited range of motion in the elbow, tired and still a little sick.) So we sat down to lunch and Tim laid down on the booth in the restaurant.  I wanted to cry.  Fever was coming back and he was again increasingly weak and tired.  The elbow was hot, swelling again and more painful to move. Now what?!  We headed to the guest house to unpack, rest and re-group. We called the British doc and were again blown completely off. But he did say we could come back to have the fluids drawn off again if we wanted to help with the swelling in the joint. Gee thanks. We worked on a contact at the international hospital that at least seemed to take me seriously on the phone and wants to see him first thing in the morning.
Now, I'm sitting here, 9:45 at night, Tim's pressures are back down below 90, fever back up over 100, pulse tachy.  I don't want to give IV fluids or abx because then he will feel better by morning again and they won't take us seriously. So we are pushing PO and trying to wait. (still with good output I think) And again I won't sleep because I know sepsis goes bad fast and every fiber of my inner IIU nurse is screaming that it is insane to not treat what I know shouldn't be ignored.  Ahhhhh!  There may very well be another 2am post tonight. Please keep praying.