Well, so much for best laid plans. Ronan is back in the hospital tonight. He spiked a fever this evening and since he is neutropenic right now (has low enough cell counts to be very vulnerable to infection,) he gets an automatic admission. 

It is debated as to why this happens to kids on chemo. Sometimes there is actually a source of infection like a central line, food born illness, etc. and sometimes they never find a source. There is some thought that neutropenia itself is sometimes the cause. However, the risks for someone with his cell counts if there was a true infection are extremely high. So, here we are.

I am very grateful that it happened today instead of Friday evening right after we got home. It went very smoothly. I contacted the on-call pediatric oncologist, and they gave the ED a heads up. We took the tram from RMH since it was rush hour and when we got here, they were ready for us and had a room waiting. Two fantastic nurses accessed his port, got a blood culture and labs sent, gave him a bolus of fluid and some antibiotics, all within probably 45 min. Then we hung out down there for a while waiting on labs and then a room. 

Ronan was pretty nervous coming in and seriously who could blame him after last time?? He did great though. He has already become so good at letting them access his port and Bryce had the good sense to put EMLA cream on it tonight as we were getting ready to leave. (This is a numbing cream that has to sit on the skin for a bit before it works.  It’s a literal life saver when kids know a poke is coming and you can plan to have it on for a bit first. They recommend use for clinic and I’m so thankful Bryce remembered tonight. 

The labs they drew tonight looked at all the cell types and how many of each there are. It confirmed that Ronan is neutropenic right now, and also showed that his hemoglobin had dropped again since Monday so they are giving blood as I write this. They give blood if his hemoglobin hits 7 and his was 6.7 tonight. It’s no wonder he felt puny and exhausted today. They also checked a basic metabolic panel which has the kidney labs and electrolytes and those looked good, pretty much the same as we here they were on Monday. They also sent a blood culture which would tell us if he has a bacterial infection in his blood stream. This one they would like to be negative for 48 hours before we can leave…hence 48 hour minimum stay. They also want him to be fever free for x number of hours or days. So there’s a chance we still get home this weekend but we will see.

One other thing is I think his body is beginning to regulate his blood sugar better again. We are not giving his long acting insulin overnight tonight at all after some lows this morning even after losing dose last night. He’s needed very little insulin all day so here’s to hoping! There will be times he needs steroids again and this could happen again when he does. But for now this is a victory and we’ll take it. 

It’s disappointing to be back in-patient again to say the least 😣but hopefully this will be a short and un-exciting stay. One of my favorite docs was here when we got here which was so nice to see her familiar face. She was with us on our first several rough days here and she’s fantastic. 

Ronan is sleeping peacefully, getting his blood. Home feels far away. BUT it is kind of nice that the first time this happens, we were up here. These fever and neutropenia events happen and are somewhat expected. I know exactly what smooth looks like at this point. I’m happy for Ronan it all went so smoothly too. Poor guy has been through so much. :( He is already so good at advocating for himself too for how he’d like to approach things or when he needs a break, etc. He is so much wiser than his years. I’d give anything to end his suffering and I wonder how these experiences will shape the man he becomes. I hope he remembers the love and support we’re giving him as much as these traumatic experiences. A friend of mine had a nursing student who had ALL as a kid and that’s what he said he remembers most ♥️

On the home front, poor Tucker has developed a little growth on his leg that is apparently cancerous 🤦🏼‍♀️ The vet initially thought it wasn’t and turns out is is. He is having it removed on 7/25 and it sounds like they are pretty confident it’s local still?? Gosh I hope so. I’m not sure I can handle losing our dog right now too and I certainly don’t want the boys to have to. Fingers extra crossed for a happy outcome there…don’t we have enough cancer to deal with already? Seriously. 

Other than all that, we continue to wait on results from the bone marrow aspiration on Monday. Very preliminary results look positive but they are preliminary for a reason and we await the big confirmatory tests before we celebrate. Please keep praying and sending healing, healthy wishes to our guy (and Tucker too!)