Posted by Steph in
Chemo Round 6 & Transplant, Counts, Infection, on Tuesday, March 20. 2007 at
Day 7 post stem cell infusion
Well, I crashed at 8:30pm last night. I sure was tired. I woke around 11:30pm, saw nurse with Asher and took a bathroom break, and then back to sleep, but not very good sleep, and at 1am Asher was calling out. He wanted a drink of water. I gave him one and then put my hand to his head and knew his fever was back. It was 39.9 ( 103.8 ). Not too bad, going all those hours without a fever! He was actually able to skip a dose of Tylenol, but got some at 1:15 now. He had also thrown up, said the nurse, as I got back from the bathroom. He went a lot of hours without throwing up too. Vancomycin seems to be helping.
The nurse also told me she had an hour break so she put TPA in one of Asher's lines and they draw now.
As I was writing the date, I realized my baby girl is 10 months old today. Can you believe it?! Since Asher was diagnosed the week she was born, I'll always remember the dates, the time.... Asher buddy, you have come a long way in 10 months and so many people love you and pray for you and are proud of you. Your mommy is at the top of that list.
Asher has 14 little baby cells. That means his bone marrow is working and that is why his ANC is going up. Woohoo!
band neutrophil 14
PT Time 18.4
Fibrinogen 663 (200-420)
D-Dimer 31510 (<230)
Vancomycin Trough 3.4 (5-10)
Vancomycin Peak 12.8 (15-40)
Potassium 2.5 (3.6-5.2)
Magnesium 1.6 (1.7-2.4)
Asher's fever didn't last long and then he got another dose of vanco and now at 7am he has a fever, 38.7, again. He just got a dose of Tylenol (after throwing up). He actually told the nurse, "I'm tired, leave me alone." It's good to see him talking and expressing himself. He's doing well.
Asher's transplant NP said she isn't doing the chest xray; Asher's lungs sound good and he didn't get much fluid yesterday and he peed out all the fluid from the night before.
Asher is about to get FFP because his DIC is higher today.
His diahrea is slowing down, but he has vomitted several times this morning. He keeps begging for milk but does end up drinking the water I give him, which sometimes makes him throw up again.
His temp at 8:40am was 38.4.
The bacteria in his blood is in the Gram-positive cocci family and we're hoping for it to be narrowed down today.
Vanco level was a bit low in his blood from this morning and so the next 3 doses will be increased.
They changed their mind during rounds and Asher will be getting a chest xray today.
Asher also got Potassium today.
This morning, right after my last update, the social worker came and chatted with me. I'm not sure why I haven't called to chat (and have a good cry) with her before....guess I'm not one to ask but I like her and she's easy to talk to. She's special for the transplant team. So I only just met her the week before Asher was admitted. She asked me a couple of questions, one of which was, "How are YOU feeling?" It isn't asked often. A few people have asked me and when they do I break down into tears. As the social worker said to me, I'm carrying some heavy things around with me right now, so that's been difficult. The doctor and NP came in to check on Asher and talk to me, so she left, but she said she would be back. After talking to her today I realized I will probably seek some type of counseling, if that is what I should call it, in the next few months. It was something I knew would be inevitable, as the last 9 months have changed me, in many ways, but carrying around so many heavy things on my heart and mind is not healthy for me.
Asher and I had a good early afternoon together. I think he woke up around 12:30pm. First time for the day. He played Game Boy and about 15 minutes later he fell asleep playing it, woke for a second, turned off his Game Boy, and while holding it still with one hand, fell back to sleep. But it didn't last long. He didn't want to sleep anymore. At that point I ran down to the cafeteria to get some lunch and Asher wasn't thrilled with me but watched TV while I was gone. After I ate, I brought Asher to the couch with me because he wanted to play "Snow" and "Christmas" (those are keywords for Sims2 because I got the new Seasons add-on). So, we played Sims2. It began snowing, and enough ended up on the ground that I had Asher (in the game) go out and make a snowman, with Daddy (in the game) helping. Asher had fun watching them. But, right after that, in the game, a social worker came and took all three kids away! Asher had been outside for too long and Aubree was crying in her crib too long. Asher was quite upset and he kept saying, "The witch took my kids away!" I don't know where he came up witch. In any case, we went back to "neighborhood" without saving and were able to go back in and play some more.
That's when PT came in to stretch Asher's feet/ankles. She's really good about not asking Asher to move. She just sat at the other end of the couch. She said Asher feels good, and even is 'helping' and 'pushing back' while she stretches him. I told her he walked to and from the shower last night, not too happily, but he did it. I noticed today when I try to change his diapers, his legs really hurt. He gets a bit upset when I make him stand on his feet and he says his feet hurt. I was told by the pain lady to push the button before I touch him, pick him up, or make him stand, and I still have a bit of trouble remembering to do that. Today I did when we went to the shower.
Speaking of his PCA....he didn't push the button at all yesterday and now today we did it two times this afternoon, but we're going to lower back down to 0.1/hr tomorrow. That way we can see if Asher needs more he can push the button, which is better than over-drugging him with morphine.
While PT was in, OT came in. She just said to let her know when Asher is back to himself (not really what she said, but what she meant). She said it might be 2 days before he goes home or outpatient, but he needs to be in cooperative manner to be evaluated.
So, after PT left, the chest xray guy came. Asher wasn't thrilled about going back to his bed, but I promised he could come back to the couch and play, which is what we did (he played Peggle Deluxe on my laptop)....until he overfilled his diaper (and he said, "someone smells")....then I took him to the shower and he had a dressing change at 4:00pm.
It is a bit more red again at the Broviac site on his chest....they are using bacitracin on it. The NP happened to come in at that moment so she saw it at least.
The owie on his butt (where his skin graft was taken for his head (which didn't take)) looks a little bit more owie today....like a big blister that popped, but it wasn't a blister to begin with. I don't think it is healing too well because it is getting too wet in his diaper (although I'm covering it with bacitracin and gauze and most of the time it does stick unless he has a monstrous diaper, which he has the last two times today. It is more pee than diahrea though...the nurse agreed and thought even 90-10, which is what she told the NP at 4pm.
Oh, and the NP told me they know the bacteria in Asher's blood...."Enterococci."
Asher sounds a bit stuffy, again, to me, with his nose running a bit before and after his shower. It hasn't been a huge issue so no one has really even talked about it, I don't think.
So, that's been our afternoon. Asher has very little energy and when he is awake, I can tell he is fighting to keep his eyes open. He still only opens them about 1/2 way too.
18:30 Changed another nasty diaper (that's 4 since 7am)....and, fever 39 (102.2) is back - gave Tylenol
19:30 39.1 (102.4)
I was laying in Asher's bed by him playing a game and he fell asleep at 10pm and I didn't even realize it till the nurse came in.
He had two nasty diapers, around 8:30pm and 9:30pm, but this time they had some blood. The nurse called the doc on call and she said it is to be expected due to the mucositis. Course, I am more worried than that due to the C.diff....
Around 9pm Asher freaked me out, with the way his eyes were wiggling and the puffy face and his not wanting to get off his pillow....he said to me, "I can't see." He still hasn't opened his eyes more than halfway and now it looked like he wasn't looking at me. Then I opened his right eyelid and saw a ton of eyelashes in there. I washed my hands and then worked on cleaning his face, including his eyelids. I mentioned it in an early blog entry that Asher's eyelashes had finally fallen out but new ones had started to grow. So, they are not very long at all and now these are falling out, but instead of onto his cheeks, they are going into his eyes. He seemed fine once I washed his face and eyes and he sat up and wanted to play a bit.
Asher did mouth care (just Biotene and Nystatin) three times today, although one this morning he threw up after. I'm also able to brush the front of teeth in the front of his mouth with the green sponge. I don't dare do more or I'd gag him.
Today, Asher enjoyed opening 4 cards that came in the hospital mail and 1 from home. He gets very protective over them after he opens them.
The good news for me to go to sleep on is his temp is 37.3 (99.1) right now and he hasn't vomitted in many hours. It may spike or he may throw up tonight, but I feel like he's getting better.