Day 23 - Nausea, but numbers are up... like really up...

Ryan is doing really well.  He has some nausea, and has been throwing up today.  But, it's not too bad, just the water and tea he's been drinking.  But, on the really good side, his numbers are really, really up.  His ANC yesterday was 650.  Today, it was 2380.  The doctors are trying to be surprised, but this is Ryan and nothing he does anymore surprises them.  I wouldn't be surprised if the nausea was related to his very rapid increase in ANC or WBC, meaning his body is simply repairing itself.

We are changing some of his IV medications to oral medications, in preparation for discharge, which might happen sometime this week... maybe.  And yes, that means going home with a hole in his tummy, which is another interesting thing.  The hole in his tummy is healing itself.  It's still open now, but his output is decreased, and it would totally be Ryan to close his own ostomy.

We had PT come by today and get him out of bed and doing some exercises.  He was very not impressed, but did the work anyway.  He is still able to stand and walk around, which is really good.

I decided to allow myself a night in a real bed, so after checking with his night nurse, I headed back to the apartment to sleep in a real bed, where there were no monitors or IV pumps.  Ahh, the simple things in life...

We'll see what the plan is tomorrow...

Thank you all for the prayers and good thoughts...

-----------------------------------------------------------------


ANC - 2380 (up from 600)
Hematocrit - 25.3
Hemoglobin - 8.7
RBC - 3.00
WBC - 3.5
Lymphocytes - 770
Creatine - 0.3
Glucose - 113
Platelets - 253

Description of lab numbers, in layman's terms:

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)
RBC (Red Blood Cells) - The number of Red Blood Cells in his body.  Normal is 4 - 5.5.  He has always been low, so we are happy with numbers around 2.5.  This number will go down with chemo.
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.
Lymphocytes - Non-cancerous T-Cells and B-Cells.  Normal would be around 1000, so we expect this number to be low.  This is the number of cells that will kill off bad cells like viruses.
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.
Bilirubin (Direct/Indirect/Total) - Bilirubin tells us how well the liver is working.  Normally, these numbers are less than 1, which is good.  However, when the liver starts to be under stress, they may go up.  Total Bilirubin is the Conjugated (Direct) + Unconjugated (Indirect).  The doctors said these numbers might come up, as his liver is trying to process all the meds we are giving him.
ALT/AST - these are liver numbers, letting us know how much stress the liver is under.  Normal range is between 10-50.