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.