We are back in Randall right now, a semi-unexpected trip, but they did warn us this would most likely happen, and they remind us it's only our first fever admission!
So let's all gather around and sit in a little circle and talk about science. Because it's interesting, that's why.
There are four types of white blood cells - neutrophils are the most plentiful, and are very important in the immune system. Neutrophils are the paramedics of our bodies, driving around and making sure everything is going well. But they are pretty cool too because they have this magic ambulance that's not limited to the road of your circulatory system and they can transport through the walls of veins into your tissue. So when you get a cut or bruise or get some bacteria or a virus, they come swooping in with their capes and save the day and heal it.
Chemotherapy works by killing off rapidly dividing cells, and cancer grows with rapidly dividing cells. But along with the killing the bad, it also kills off the good rapidly dividing cells, and that includes those neutrophils. After a treatment of chemo, about 3-7 days, the neutrophils will start getting low. This is one of the reasons we go into clinic twice a week after the chemo days, to check his blood counts and liver function and a whole list of other things. Last week he had to get re-hydrated, so they accessed his port and plugged him into hydration, drew his blood, tested it all. Monday, they drew his blood and he showed up as neutropenic, meaning his cell count is below 500, the goal is to keep it above 1000.
When Atticus becomes neutropenic, we start watching for fever, because it could mean he's sick, or has an infection that his body will not be able to fight off on it's own. There is a whole list of rules of things to look out for, fever being one; any fever equal to or greater than 100.4F twice in 12 hours, or 101F once, to call the clinic! Fortunately Atticus at his age is able to feel and communicate when he's not doing so well and take his own temperature.
Dad and I were out driving my car to the shop yesterday morning and on the way back, I got texts from my mom and Atticus saying he had a 101 fever. We got home and I called the clinic and they said come in ASAP, so we did.
Here's the fun thing (no? Not fun? Wait, cancer isn't FUN?!). It could be something, it could be nothing. Prompt care is the most important. Fortunately, we live pretty close to the hospital and my parents had a rental car so they were able to deliver us to Randall.
The nurses had to access both sides of his port to make sure there was no bacteria anywhere in there. They draw blood and start hydrating him through IV. The next part of essential treatment is a full blood work up, and to start antibiotics right away, so they added that to his IV as well.
They then tell us that a room is being cleaned on the fourth floor and we will be admitted for 48 hours, which leads us to Friday noon-ish or, you know. Whenever.
During this time, in the Super Hero Lab, they are growing all sorts of cool things in his blood and trying to figure out what's going on in his body. It could be something. It could be nothing. We always hope for the nothing. I mean, besides the cancer, we already know that.
They also need to watch his fever, make sure he's not getting more sick, make sure all his vitals are in good order and general upkeep on a neutropenic patient. Tomorrow they see if anything exciting grew in 48 hours and make sure he's as healthy as could be expected and we go home.
With more rules, of no mountain climbing, no rock concerts, no opening day at the hit movie. All things that sound pretty horrible to me too, so that won't be a problem.
He is suffering from some Mucositis, again, to be expected with this treatment, but not fun.
This is definitely an easier trip to the hospital, he is comfortable, able to move around more, cognizant of his visitors and the goings on. We have one of our night time nurses from before, we just love him, and a new nurse named Joshua we met today who is also super cool.
Now we all learned about Neutropenia and why we have to go to the hospital when fevers and kids just normally go together, but with chemo patients... its a hospital stay!