10.23 7am from Matt:
Dr. S just came by. Mollie's WBC are the same as yesterday (0.5), and her other measurements (HgB, Hct and platelets) are roughly the same as well. No ANC yet (I hate it when they come in here without it). She had tylenol at 9p last night and had slept well since then. Cefepime at midnight, then normal temps at 1A and 4am, vancomycin around 5am. He also mentioned that her IgG levels were low, but not so low that they would need to transfuse her. I was happy to hear that, Mollie had an infusion to bolster her IgG level during her December stay and had a reaction to it - one of the scariest moments we have had during her treatment.
So, at this point we are at 10 hours and counting with no fever. Need to get to at least 24 before we go anywhere.
Update (1:30 pm) and FAQs:
We missed the doctors rounds this morning because Matt and I were doing the "Lucy exchange" downstairs. Mollie reported that Dr. B told her to keep blowing her nose. I'm sure if there was a change in "the plan", Dr. B will come back and let us know.
Mollie's temp was 37.8 @ noon; now she feels warm to me so I wouldn't be surprised if it is higher.. She just had a session with the school teacher, Ms. Pam. They did a lot of the make up work that her teacher sent last week and she enjoyed being out of the room and getting attention from someone else! Mollie didn't eat any of her lunch (don't blame her- it looked unappetizing) and doesn't want the bagel I got her (they didn't have plain, ugh) so she's grouchy and hungry. She only wants french bread and cheese or a bagel from Einsteins or vanilla yogurt. I'm going to try to get her to eat some cereal.
A few people have asked about blood counts and ANC. Every time they draw "labs" the blood is sent for a CBC (complete blood count). This measures the number of red blood cells (RBC), white blood cells (WBC) and platelets in the blood sample. Neutrophils are a type of white blood cell that is the body's main infection fighter, but only a percentage of white blood cells are neutrophils. The ANC (absolute neutrophil count) gives the total number of neutrophils and is a measure of infection-fighting ability. To get the ANC, they have to do a differential count, where they look at all the white blood cells and then calculate the percentage that are neutrophils, lymphocytes, monocytes, etc. They multiply the total white cell count by the % neutrophils to get the ANC. An ANC below 500 is considered neutropenic and requires special precautions to reduce the chance of infections.
Another question is why the temperatures are reported in Celsius. I think most hospitals now use the metric system exclusively. Pediatric medications are usually dosed in mg/kg body weight, so for consistency, I think they measure everything using the metric system.
Julie, we don't have a printer here, but Matt and I are switching shifts at least 2x per day so we can print things from home and bring them here.
Update @ 4:30 pm: The fever continues (38.4 @3:15). She got some tylenol about an hour ago, so hopefully that will bring the temp back down. Dr. B says keep waiting- she may have a virus that won't respond to antibiotics and just has to run its course.
Mollie is in a good mood though- she's been using the nurse-call button as a microphone!