So, this is good, right?
After yesterday's exhausting emotional day, today was quite boring. The CT scan (with contrast) and xrays we took this morning showed no other ruptures in his intestines. The contrast moved from his stomach, to the new ostomy and to his bottom. No obstructions. No leakage of the intestines. So, that's all good.
If I understood the GI doc this morning, it is not unheard of for the intestine to break through the skin and rupture, as Ryan's did yesterday. For anyone interested, it is called a "Enterocutaneous Fistula"... The internet articles are not pretty...
In his case, we think this is part of his original ostomy (from his transplant 11 years ago). When his (absolutely amazing) surgeon at UCLA closed up his ostomy, a small 'pocket' was left. It's possible that with the 'trauma' of the chemo meds, this pocket got infected and ruptured. We are so lucky that he is on every antibiotics under the sun (ok, that's a slight exaggeration), so this is not causing any problems with sepsis (a very bad reaction to an infection). In fact, the rupture seems to have solved all Ryan's issues. His heart rate is down (in the 80-90 range when sleeping), he has NO fever. He still has some pain, but it's manageable. And, he's getting up and walking around. He actually feels much better!
That being said, he currently has an ostomy, with an ostomy bag attached to his belly, where stool and stomach acid are leaking out. If you saw the pictures yesterday, or have ever seen him without a shirt on, his belly is NOT flat... It's full of scars and ridges, which make keeping an ostomy bag on his skin very hard. We are doing okay today, but I expect that over time, the skin will begin to break down from all the acid. Of course, the catch-22 is that we can't surgically go in and fix things until his numbers improve. (there is that silly little cancer thing still going on).
So, we're in a holding pattern, with no surgery or chemo. We will just wait, and watch, and pray that his numbers improve. The good part is that he feels so much better. He slept peacefully, he watched movies and played games on the Xbox. As long as he feels good, I'm okay being patient. We'll see how things go tomorrow...
Thank you all for your continued prayers and good thoughts!
------------------------------------------------------------------
ANC - 80 (down from 250 this morning)
Hematocrit - 22.0
Hemoglobin - 7.2
RBC - 2.40
WBC - 0.3
Lymphocytes - 210
Creatine - 0.2
Glucose - 79
Platelets - 26 (he's been getting platelets daily, trying to get this number back up)
ALT - 44
Total Bilirubin - 1.9
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.
Comments
Post a Comment