Day 10 - Watching and waiting...
We were a little optimistic, thinking that we might get discharged soon. The doctors are being extra careful with Ryan (which is kinda typical). Patrick had a long talk with the Oncology Attending, and they explained some of their fears and concerns. With Ryan's TPN, he has a higher chance of getting a fungal infection, which would be really, really bad. So, they are keeping a close eye on his glucose numbers, to make sure his pancreas doesn't start to struggle.
So, we probably will remain in the hospital for the next two weeks, until the Induction phase is over. There is always a possibility that they might let him go, but for now, we are going to take a 'wait and see' approach. If he does start to develop any signs of kidney or pancreas, they want him in the hospital so they can catch it early.
This news isn't all that surprising, but it does kinda suck. As usual, when there are lots and lots of people talking to you (Attendings, Fellows, Residents, etc from Hematology, Oncology, Infectious Disease, Pediatrics, Transplant and Liver), everyone has their own ideas on how things will go. In the end, no one wants to overrule anyone else, so you only get discharged when EVERYONE agrees. So, even though the doctors over the weekend thought we could go to the apartment on Tuesday or Wednesday, the doctors today had different plans. Always frustrating and difficult, especially to Ryan who doesn't really understand why the doctors won't let him leave.
His numbers dropped today, quite a lot. He is still at okay numbers, so it will depend on if he drops more tomorrow, or if he holds steady.
Thank you all for the prayers and good thoughts!
(p.s. Sorry, no picture tonight... Patrick forgot to take one!)
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Blasts - 0
ANC - 1039 (down from 1539)
Hematocrit - 22.3 (down from 26.3)
Hemoglobin - 7.6 (down from 8.8)
WBC - 1.3 (down from 1.9)
Creatine - 0.4
Glucose - 89
ANC - This tells us how well his body can fight off normal infections... We want this to be greater than 500.. Normal would be greater than 1500.
Hematocrit/Hemoglobin (H&H) - This is a number of how much blood is in his system. His normal range is 28-32/9-11. The numbers are linked, so they are usually referenced together. We will transfuse him more Red Blood Cells if he gets below 21/7.0. (this is the blood you donate at blood drives, and we expect to use lots of it)
WBC (White Blood Cells) - This tells us how many white blood cells he has (in thousands). Normal is between 4.5 and 10. We expect this to remain low, between 1.5 and 2.5 for a while.
Creatine - This is a good number to make sure the kidneys are working. Normal range is between .5 and 1.2... If this gets higher, it means his kidneys are struggling.
Glucose - This number tells us that the pancreas is working. Some kids struggle with diabetes as a result of the meds. We want to see this number remain above 60 and below 150.
So, we probably will remain in the hospital for the next two weeks, until the Induction phase is over. There is always a possibility that they might let him go, but for now, we are going to take a 'wait and see' approach. If he does start to develop any signs of kidney or pancreas, they want him in the hospital so they can catch it early.
This news isn't all that surprising, but it does kinda suck. As usual, when there are lots and lots of people talking to you (Attendings, Fellows, Residents, etc from Hematology, Oncology, Infectious Disease, Pediatrics, Transplant and Liver), everyone has their own ideas on how things will go. In the end, no one wants to overrule anyone else, so you only get discharged when EVERYONE agrees. So, even though the doctors over the weekend thought we could go to the apartment on Tuesday or Wednesday, the doctors today had different plans. Always frustrating and difficult, especially to Ryan who doesn't really understand why the doctors won't let him leave.
His numbers dropped today, quite a lot. He is still at okay numbers, so it will depend on if he drops more tomorrow, or if he holds steady.
Thank you all for the prayers and good thoughts!
(p.s. Sorry, no picture tonight... Patrick forgot to take one!)
--------------------------------------------------------------
Blasts - 0
ANC - 1039 (down from 1539)
Hematocrit - 22.3 (down from 26.3)
Hemoglobin - 7.6 (down from 8.8)
WBC - 1.3 (down from 1.9)
Creatine - 0.4
Glucose - 89
Description of lab numbers, in layman's terms:
Blasts - roughly the number of leukemia cells found in the sample. We want this to be 0.ANC - This tells us how well his body can fight off normal infections... We want this to be greater than 500.. Normal would be greater than 1500.
Hematocrit/Hemoglobin (H&H) - This is a number of how much blood is in his system. His normal range is 28-32/9-11. The numbers are linked, so they are usually referenced together. We will transfuse him more Red Blood Cells if he gets below 21/7.0. (this is the blood you donate at blood drives, and we expect to use lots of it)
WBC (White Blood Cells) - This tells us how many white blood cells he has (in thousands). Normal is between 4.5 and 10. We expect this to remain low, between 1.5 and 2.5 for a while.
Creatine - This is a good number to make sure the kidneys are working. Normal range is between .5 and 1.2... If this gets higher, it means his kidneys are struggling.
Glucose - This number tells us that the pancreas is working. Some kids struggle with diabetes as a result of the meds. We want to see this number remain above 60 and below 150.
Platelets - This is the number of platelets in the blood, which helps with clotting. Normal is greater than 150. We will transfuse more platelets if he gets lower than 30.
Co-Ags (PT,APTT) - These numbers tell us how fast he clots.
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