Day +15
WBC 1.4
Our poor Max is not doing well today. He has been vomiting every 2 hours or so since yesterday. He also has bad diarrhea. He lost 2 lb over 24 hours and he is slightly dehydrated. They have increased his fluids, added another anti-nausea med, and given him morphine and ativan for the pain and discomfort. There are flecks of blood in his vomit, probably caused by broken blood vessels. A CT scan of the head was ordered and then cancelled due to the risks of sedation with Max. There are 5 possible reasons for all of this, some much scarier than others:
1. Effects of chemo - Although it is a bit late in the game for this every kid reacts differently.
2. Reaction to his new blood pressure med - They changed his med a few days ago because of the rash (which by the way looks so much better), and he may be reacting to the new med. They have discontinued it so they can rule it out.
3. Virus - They are checking his stools for this.
4. Hydrocephalus - Dr. Charnas, Max's neurologist just ruled this out. If it was hydrocephalus we wouldn't see the messy diapers along with the vomiting, and the vomiting would be different. His fontanelle feels softer today than yesterday.
5. Dreaded Graft vs. Host Disease (GVH or GVHD) - We are looking for signs of this. There would be more blood in his vomit and vomit in the stools as well. They are monitoring his bilirubin for his liver as well.
We are very relieved to hear Dr. Charnas' opinion and pray that this is not GVH, but rather the chemo. Max looks so sick today. He can barely sit up and has had trouble sleeping. He is finally sleeping soundly so I am off to sleep myself. I am hoping he wakes up in the middle of the night feeling much better and ready to play.
-Margaret
Our poor Max is not doing well today. He has been vomiting every 2 hours or so since yesterday. He also has bad diarrhea. He lost 2 lb over 24 hours and he is slightly dehydrated. They have increased his fluids, added another anti-nausea med, and given him morphine and ativan for the pain and discomfort. There are flecks of blood in his vomit, probably caused by broken blood vessels. A CT scan of the head was ordered and then cancelled due to the risks of sedation with Max. There are 5 possible reasons for all of this, some much scarier than others:
1. Effects of chemo - Although it is a bit late in the game for this every kid reacts differently.
2. Reaction to his new blood pressure med - They changed his med a few days ago because of the rash (which by the way looks so much better), and he may be reacting to the new med. They have discontinued it so they can rule it out.
3. Virus - They are checking his stools for this.
4. Hydrocephalus - Dr. Charnas, Max's neurologist just ruled this out. If it was hydrocephalus we wouldn't see the messy diapers along with the vomiting, and the vomiting would be different. His fontanelle feels softer today than yesterday.
5. Dreaded Graft vs. Host Disease (GVH or GVHD) - We are looking for signs of this. There would be more blood in his vomit and vomit in the stools as well. They are monitoring his bilirubin for his liver as well.
We are very relieved to hear Dr. Charnas' opinion and pray that this is not GVH, but rather the chemo. Max looks so sick today. He can barely sit up and has had trouble sleeping. He is finally sleeping soundly so I am off to sleep myself. I am hoping he wakes up in the middle of the night feeling much better and ready to play.
-Margaret
posted by Mike Ciacciarelli
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