Wednesday, January 9, 2008
I hate that I even have to put this update on here, but none the less this is our reality. The blood cultures came back the opposite that we would have wanted. There is a strep bacteria that grew and so we are stuck here until next week at least. The oncologist came to talk to us his morning and gave us a better idea of what to expect for the next couple of months. I can't decide if his glass is half empty, or he just doesn't want us to be surprised. It sounds like there is a pretty good chance that we will be here fairly frequently in the next month or two. This is where it gets confusing, so I'll try to explain it how I understand it. When they do blood work on Elijah they look at lots of different numbers to explain one common thing, no immune system. At first we thought that it was all due to the low WBC count. A big part of it is, however they are other things that play into that. The other major thing that they look at is his neutrophil count. I believe these are the cells that will help to start making the "good" WBC (as opposed to the "bad" ones or the leukemia cells also known as blasts or baby cells). The oncologist said that it isn't necessarily the antibiotics that is keeping him here in the hospital because sometimes we can even to antibiotics at home. The fact that he continues to spike fevers, and now Tylenol isn't bring them down in combination with his neutrophil and WBC are what is keeping him here. They want to see his neutrophil count at 500 minimum and right now his is O!!! So the fact that he has developed an infection didn't seem all that surprising to Dr. Al-Zein. He doesn't think that these will start to rebuild until next week sometime. They also drew more blood to test for a fungal infection that is common in kids with leukemia. Dr. Al-Zein decided to start an antibiotic that will also cover a bacterial infection just to get it in his system, and if the culture comes back negative for the fungal infection they will stop that antibiotic. So currently he continues to get the antibiotic that was started in Iowa City, which is a broad spectrum antibiotic, and then he started another one today that will target the strep bacteria. (three antibiotics altogether) They just put him on a cooling blanket to help bring down his fever since the Tylenol isn't doing the trick. Hopefully with the combination of the two, it will start coming down soon. His fever has been between 101.8 and 103.0 since about 07:00. As you can probably imagine, he is very cranky and feels awful. Dr. Al-Zein said that he will most likely start Elijah back on the IV nutrition tomorrow since he is still not eating. He also told us not to be surprised if Elijah has to have between 2-3 blood and/or platelet transfusions in the next week. They just gave him some platelets this afternoon because they had dropped to 12K (normal is 120K-150K, but he has to stay above at least 20K to not have a transfusion). His hemoglobin has also dropped to 9.1 from between 11-12 that it has been the last couple of days. If his hemoglobin drops to 8 or below, he will receive blood. They are going to start him on a special mouth wash because of the soars in his mouth, because Dr. Al-Zein said with his counts the way they are, this has a good chance to get worse. So yet another few bumps in the road, but Elijah is being well taken care of and will hopefully overcome this too. Dr. Al-Zein said that although it is better to have a viral infection, they can treat the bacteria infection and get him better. I have heard some worried comments about people visiting since he got this infection but I just want everyone to understand the difference between a viral and a bacterial infection, or at least the way I understand it. I think that I have mentioned in a prior post that Elijah's body is it's own worst enemy, especially when it comes to bacterial infections. Most likely this infection came from within his own body. If it were a viral infection, then we would know that it probably came from an outside source. So, if you would like to come to visit, we would love to see you as long as you haven't been sick, or think you might be please send us a comment instead. Dr. Al-Zein did stress to us how important it is to wash our hands, so that will become a very important aspect of our lives. He even told Levi and I to change our clothes when coming home from work. Just common sense things really, but not something you would think about with a healthy child. That's all for now, hope I can have a happier update later or tomorrow. Love you all!!