May 23, 2013

Today, SD was in much better spirits! Yesterday he was starting to perk up, and today he pretty much returned to his normal, happy self!

We got the word on SD's counts today late this morning; his ANC is now around 2000! The doctor here and the oncologists downstate have agreed that he does not need another Neupogen shot, so that means we can go home today!

SD still has quite a cough, so he is still in isolation. However, his immune system has sufficiently recovered enough for Emma to come in for a visit. Here they are both watching Chip & Dale on the laptop.

So, this won't be our longest hospital stay, but it does qualify as our most electronic! We currently have three laptops, one iPad, and a portable Wii in our room. SD has really enjoyed playing Mario Galaxy 2 with us the last couple of days.

SD will not resume his chemotherapy immediately, though he will be on an antibiotic for a week or so. The next few weeks will be a bit rough; he'll have to go in fairly often for blood work and some "catchup" on his medications.

But for now, we're just glad to be going home!

May 22, 2013

Not much changed regarding SD's condition yesterday. He was extremely sleepy all day long and his counts had stayed about the same.

There was a severe thunderstorm warning on Monday, so Grandma Cleary waited until yesterday to bring Emma down so we could spend some time with her. We hadn't seen her since last Thursday, so we certainly were missing our sweet little Sunny! To our surprise, she decided that she was Daddy's girl during our outing, but was obviously very happy to see both of us again. :) She didn't get to see SD but at least she got to hear his voice from the hallway.

We took Emma out for lunch and a short excursion to the mall, and spent a bit more time with her again after dinner. We can hardly wait until we can all be together again!

Today (Wednesday), SD's neutrophil count came up from 0 to 37. Not a dramatic difference by any means, but it is an increase. The neutrophils need to be over 500 before he can go home. He endured his fifth shot of Neupogen this afternoon, so we are hoping that it will start taking effect by tomorrow. It's never taken this long to start working in the past, so we are rather surprised to still be here at the hospital. It's beginning to look like this will end up being his longest hospital stay ever! He does appear to be on the mend today, though. He's perked up a bit and has been able to eat a little more. Not much more, but there is a noticeable difference.

May 20, 2013 (Part 2)

Dr. Lamphere just came in with surprising news. After two days of Neupogen shots, SD's white counts have actually gone down rather than up!

When SD has gotten Neupogen in the past, it would always cause his white blood cell count to skyrocket. Instead of skyrocketing, his white count went down to around 0.7 while his ANC (an estimate of his infection fighting capability) is virtually at zero.

This is the first time we've dealt with a "neutropenic fever" without a clear cause, but the doctor acts like it's not unusual (in cancer patients). Since we haven't been able to figure out what infection SD is fighting (blood cultures are still all negative, his recent chest X-rays are clear, etc), all we can do is wait for SD to kick it and help him as much as we can. So, he's staying on a broad-spectrum antibiotic and will continue receiving daily Neupogen shots.

In order to go home, we need to see:

1. No fever for 48 hours. Check.
2. Negative blood cultures. These take a few days to check, but SD's have all come back negative so far. Check.
3. Any known cause of the infection to be cleared up. Since we haven't been able to determine an actual cause for SD's illness, he passes this one too. Check.
4. Blood cell counts trending upward. SD's are currently trending downward.

So for now, please pray that SD's white blood cells will recover and start trending up, and that his fever does not return. If he gets a fever again, we'll need to "reset the timer" on the fever and blood culture checks, spending at least another two days in the hospital.

Dr. Lamphere said there is a (small) chance we could go home tomorrow, but he has seen other cases where it took a week. As of now, we can't guess when we're going home.

May 20, 2013

SD slept *a lot* yesterday. He took three naps during the day and still slept well through the night. Around midnight he was up for about 20 minutes when the nurse came to check his vitals and administer his meds; he popped up with a big smile and asked to use the iPad. Since he wasn't going to sleep while the nurse was there anyway Mandy told him he could while she was there. He was ready to put it away shortly after she left.

Dr. Lamphere came to our room last night to let us know that no sign of pneumonia showed up on the x-rays taken yesterday. We still don't know what this is, so SD has been in isolation and under neutropenic precautions during most of his stay. This means that anyone coming into the room (except Mom and Dad) must wear a fresh gown, mask, and gloves, there can be no fresh flowers in the room, hot foods must stay hot and cold foods must stay cold... there are many little efforts to keep anything new from infecting him further.

SD's appetite has been very poor during his hospital stay. Sometimes he decides that something sounds good, but he can only eat a little bit of it. Sometimes he takes a bite and then turns it away because his taste buds are affected. We'd really like to see him able to eat more soon!

Dr. Lamphere mentioned the possibility of going home today. He didn't sound extremely optimistic about it, but as of yesterday it wasn't out of the question to consider it. He said we'll just take it a day at a time. We haven't had his blood counts checked yet today, but this morning SD's cough is even worse than it was yesterday and has been wheezing quite a bit.

May 19, 2013

SD hasn't had a fever since yesterday morning!

Around noon yesterday SD suddenly wound down and wanted to get into bed, but said he did *not* want to take a nap. He was asleep within a few minutes, however, and slept for *five* hours! It seemed that once his fever broke he was able to sleep more peacefully than he has in days. His breathing was much closer to normal and his heart rate was much lower also.

Unfortunately his nap was rudely ended by the dreaded Neupogen shot. His white blood cell count had decreased to .5, so the doctor wanted him to start him on Neupogen to kick start an increase in the WBCs. To make up for the stinging wake-up call, his nurse brought him a fun tool set to take home.

SD's cough began to increase last night and has been much worse this morning. He's also developed a runny nose. Because it sounds like things are starting to break up in his lungs, the doctor ordered another chest x-ray. Pneumonia has not been completely ruled out yet, but the doctor said it could be something as simple as a common cold. With his imuno-suppressed state, symptoms can manifest in more severe ways than they normally would. Right now we're waiting for the results of today's lab work and x-rays. We do know that the cultures are still negative. He's had two breathing treatments so far today.

We were a little surprised today by the change in SD's disposition. While he had the fever he was being a goofy little fellow, but today he's been a lot more touchy. He's probably getting tired of being hooked up to all these wires and feeling the tape pulling at his skin. His chest is filled with various sticky tabs and tapes; three of the tabs are now unnecessary, but he will not let us near them. So they'll probably all come off at once, poor fellow. He's probably getting really bored too; we didn't take many things to the hospital because we didn't think we'd be here long.

There has been talk about the possibility of going home tomorrow. We haven't received the results of his lab work yet, so it mostly depends on how his white counts look (and if he can continue to stay fever-free). He quickly dropped off to sleep around noon again and has been sleeping soundly since. It's comforting to us to see him getting real rest.

May 18, 2013 (Morning)

Yesterday was the day SD was originally scheduled to go in to clinic and start his monthly steroid pulse. On clinic days, some of the oncologists from Grand Rapids come up to Traverse City for us northerners. One of the visiting doctors (Dr. Cornelius) stopped by yesterday to visit and check on SD. How kind of him to drop by before his long drive home! He gave some recommendations on steroids; they're suspecting SD's cortisone is low, so they're starting him on Solu-Cortef (this is a totally different kind of steroid than his regular chemotherapy steroid, dexamethasone).

Since we've been here, the doctors have had a difficult time keeping SD's fever down. He's currently on the steroid, some broad-spectrum antibiotics, and tons and tons of fluids! We also have a fan and ice packs on him (seriously). He has been taking Tylenol almost constantly since we've been admitted - not for pain, just to keep his fever in a reasonable range.

However, he is in excellent spirits. He's enjoyed spending time with both of us, and is cheerful to the point of silliness! Most of the staff here is only treated with a shaking of the head or a verbal "no", but SD decided he liked one of the nurses last night and started chatting a lot with her. SD has also voluntarily taken naps several times, which is quite unusual for us: he just announces he's going to take a nap, lies down, and almost immediately falls asleep!

When he was first admitted, they were suspecting pneumonia (based on the chest X-rays). However, they're not sure what is causing his fever now. The blood cultures have all come back negative (which is a good thing), so they just changed his antibiotic to one that affects more diseases. We're pretty much just waiting for whatever it is to run its course. Right now it looks like the soonest we could go home is Monday.

One worrying thing is that SD's white blood cell counts have been dropping. They were 2.4 when we were admitted on Thursday, 1.3 Friday morning, and 0.9 just a few hours ago. So they're probably going to do Neupogen today. This is not a fun one because it can't go in through his existing IV; it has to be injected into his leg muscle in multiple shots while he's held down. Neupogen is very painful for him. :(

May 17, 2013

SD was scheduled to have his monthly clinic check-up this morning, but is across the street in a hospital room instead.

He's had a cough for two weeks now. It was worst during the first week and has been fluctuating in frequency since then. On Wednesday he began complaining about a tummy ache and acted more clingy than usual, and this continued into Thursday. He woke up Thursday with a low-grade fever, and around 10 am crawled into our bed saying that he was going to take a nap. I thought he was playing around, but he actually did fall asleep; I think this was the first time he's ever done that. His temperature stayed steady until the late afternoon; upon calling DeVos about his 101.5 fever we were told to go to the hospital and by the time the phone call ended, his temperature had risen to 102.4. It was 103 when he was checked in at the ER.

After hours of waiting and blood draws and x-rays, the word was that he has pneumonia. He was given a hospital room, where I came later to spend the night. His fever lasted through the night. When the doctor spoke to us this morning, he said that he wants to see SD fever-free for a day or two and his white blood cell count going up before he is discharged. So it looks like we'll be here at the hospital a bit longer than originally hoped.

The doctor also said that he is not convinced that SD has pneumonia. He ordered more blood work for cultures; so far the cultures taken yesterday have not shown presence of bacteria, but it usually takes a couple days to be conclusive.

The nurse came in a little while ago to take SD's temperature and to give him Tylenol. His fever is the highest yet at 103.6; it shoots back up every time the Tylenol wears off. About an hour ago SD announced that he was going to take a nap and fell asleep almost right away. He's been sleeping since, waking up just enough to take some Tylenol a little bit ago.