Since I knew Tom's neutrophils (white cells) were at zero on Thursday night, the first thing I did on Friday morning was check his temp. He was burning up with a temp of 39.1 C.
We were already planning to head straight in to the clinic, and got there as quickly as we could. As quickly as....a herd of turtles. Tom was really in a lot of pain and his legs were very weak, so getting him upstairs, to the van, and into the wheelchair, was a challenge.
He had a temp of 39.4 in the clinic. Dr. H right away started antibiotics, and ordered blood work/blood cultures. They had planned to transfuse blood, but couldn't until the temp eventually settled down late in the afternoon. Tom's blood pressure dipped rather alarmingly, his temperature took off again, and his heart rate sped up like crazy - he gave everyone a bit of a scare - so they abandoned the plan to transfuse him. One way to help blood pressure rise is to administer a lot of fluids in a short amount of time. The clinic began this process, and then he was admitted to the hospital.
Things got kind of crazy for a little while, I don't mind saying we were pretty worried. Tom's symptoms suggested septicemia - blood borne infection. Systemic infection is life-threatening to someone with a damaged immune system. If things hadn't improved when they did, Tom would have been admitted to the Intensive Care Unit.
By late Saturday afternoon his blood pressure levels and temperature had returned to normal, thanks to the administration of large volumes of fluid, blood, platelets, antibiotics pip-tazo (piperacillin-tazobactam), vancomycin, antifungal fluconazole via IV and Tylenol orally.
So far, all the culture tests have come back negative, however it doesn't rule out the possibility something is brewing yet, because some bugs take longer to grow than others. The cultures are assessed at 24, 48 and 72 hours. If all are clear, and his temp stays down, he may be able to go home late Monday or early Tuesday.
Tom's blood and platelet levels were still low today, so he's received more of each. In addition, the antibiotics have continued. It seems to be working, his temps range from 36.9 to 37.7 this afternoon. His blood pressure has been normal all day. Normal is good. Normal is typically under-appreciated.
We are so grateful for the well wishes and prayers! We are also grateful for the visitors today! Thank you: Molly, Laura, Elizabeth, Audrey, Melissa, Austin and Jeanine for coming in.
Our accommodations are a bit different this time: Tom has been admitted to 3B, which is the adult oncology ward here. We are so used to things in Pediatrics on the 5th floor! So we miss our clinic friends and the nurses that we know so well, but Tom's done just great here. The staff are just as nice, and kindly brought in a cot for us to sleep on so we can stay with Tom.
All is well, life is good.
Signing off for now - thanks so much for checking in and keeping us in your thoughts and prayers.
Thomas' Mom
