I am writing from the emergency room at Stanford. It's pretty cushy, as ERs go, with a huge Apple computer for patients and parents. So, with nothing better to do, I blog.
We took Scarlett for her scheduled clinic visit and outpatient chemo this morning. She was doing well the last two days: no vomiting, appetite coming back, all good things. We saw the doctor, who thought she was looking great. Scarlett smiled, cooed, and was in good spirits. As soon as the doctor left, the little lady decided to barf all over the room; that projectile, uncontrollable kind of gastronomic event that only exorcists and parents have faced one-on-one. We tried to clean up the baby, the wall, the bench, the chair, the floor and Chris' clothes with the single burp cloth I brought from home and the automatically dispensed paper towels in the room. As I was frantically waving my hand in front of the paper towel machine, the nurse came in to help clean up and go on with the blood draw and chemo. All went to plan, and since she was still gagging, we gave her additional nausea medications and headed home.
We got a call a short time later telling us that her neutrophil count, which tells us the stability of her immune system, was low, and she was considered neutropenic. This essentially means that she is very susceptible to getting sick, and any fever would be considered an emergency worthy of hospital admission. While we knew this was coming (it is basically the point of chemo, to kill off the current blood cells along with the cancer), it marks a new phase of her treatment, where she is dangerously close to a whole new level of sick; even minor viruses or bacteria could run rampant in her compromised system and leave her in bad shape. However, no fevers so far.
She slept most of the evening, so I tried to get more milk into her before we went to bed. She ate eagerly, but gagged, so she got more medication. Just as I finished that dose, I gasped at the sight of the top of her head completely sunken in, like a crater surrounded by mountains of bone. After the shock wore off, we remembered that this was a pretty indicative sign of dehydration, and we called the on-call doctor for advice. He recommended we bring her in for IV fluids before the dehydration made the nausea even worse. As we packed her up for the trip, she again let loose and threw up all over the kitchen...and Chris. Definitely needed to get to the doctor, so a quick costume change and we were off.
Now it is 12:30am and we are sitting in the emergency room. We've been here a solid few hours so far while the ER doctors assess her and try to figure out all of her charts, medications and possible issues. This is my first big test of needing to know what medications she is on, what doses, when things were administered and what procedures we were told to follow. So far, it all seems to be going well. She is getting IV fluids while she sleeps on the hospital bed with Chris, who was up at 2 am for work this morning. We are hoping to go home in the next hour, as long as her latest blood work comes back ok. Not sure what will happen tomorrow...