Sunday, September 12

It's been a week since I've updated the blog, so here's a review of the last week...

Last Sunday (Sept. 5) Collin had a mid-morning nap courtesy of the Benadryl and Reglan combination he was receiving to help prevent nausea from the chemo. Again when he woke up from the nap, he immediately started screaming and crying, in a way that is not normal for him. We tried giving a dose of oral Morphine to see if he was in pain, but it didn't help calm him at all. Half an hour later we gave a dose of Ativan, and he calmed down right away. That afternoon, he had the Benadryl/Reglan combination again, but he didn't go to sleep, and he had no more screaming episodes. The pattern that day followed the same pattern as the day before, and I really began to question whether the Reglan caused some sort of disturbance in his sleep cycle that caused him to wake up screaming; the episodes were similar to the night terrors that Neya used to have when she was around the same age. Reglan can cause some pretty bizarre side effects which is why it's given with Benadryl, but I think we'll try not to use it during the next round of chemo. There are other drugs that can be used to prevent nausea instead, so it's not worth the risks.

Monday, Labor Day, was quiet, other than having to replace Collin's feeding tube after it was accidentally pulled out during a vigorous game of Pekaboo between Collin and Neya. Tuesday was another quiet day. Collin's ANC was pretty high, which the attending physician explained was because the Neupogen had caused Collin's bone marrow to push out all of the blood cells that it had been manufacturing. She told me his counts would go down to zero by the next day or so, as expected. 

By Wednesday (Sept. 8), the mucositis had started; Collin's breathing sounded kind of junky the night before, and his voice was sounding hoarse. Luckily he only spit up mucous a few times during the day. Then, around 4:00 Thursday morning, Collin threw up, and it was a large enough amount that I had to change him and the bed sheets. Later Thursday he threw up a few more times because of the mucous in his throat. He also received a blood transfusion Thursday because his Hemoglobin was low. Friday I put a mask on Collin and got him out of the room for a while. We were able to go down to the gym for OT; he had a great therapy session and enjoyed getting out of the room for a while.  

Saturday morning, around 3:00 AM, Collin's fever spiked like it always does when his immune system reaches zero. His temp was 102.6, so blood cultures and a chest X-Ray were done to check for infection, and he was started on Tylenol and two broad spectrum antibiotics to treat any infection that was brewing. Around 7:00 AM, Collin developed rigors (violent shivering) and threw up; I called for our nurse and checked Collin's temp with my ear thermometer, which read 105. He was immediately given another dose of Tylenol, which thankfully brought his fever down pretty quickly. The doctors explained that sometimes the first dose of antibiotics can cause an inflammatory reaction in the body, which causes another spike in temp. Later I was told that the cultures showed that there was indeed not one but two infections in Collin's blood. He also had another blood transfusion Saturday because his Hemoglobin was still low. Saturday night, one lumen of his Broviac was clogged, and required treatment with TPA, a drug that breaks up blood clots. Most likely the line wasn't flushed well enough after the blood transfusion, which allowed some blood to clot in the line. The TPA had to sit in the lumen for almost three hours, but thankfully it eventually unclogged the line. 

Sunday was a quieter day, and Collin seemed to feel a bit better. His breathing sounded clearer, but his voice still sounded a bit hoarse from the mucositis. He received a transfusion of platelets in the morning. He only threw up once; of course it was just after I had finished bathing and dressing him for bed Sunday evening, so I ended up having to do it all over again, and then change the bedding as well.