Thursday, June 6, 2013

A Major Curve Ball

Just when I thought we might be seeing a glimpse of normalcy...getting unpacked in a new house, having a few weeks as a family before the transplant, settling into a summer routine...life threw us a major curve ball.

Yesterday, Parrish was admitted to the bone marrow transplant unit for septic shock. I had thought that Parrish seemed a little "off" for a couple days...I kept asking him if he felt okay and he said yes. But, he was paler than usual and just off; I don't really know how else to put it. Yes, we were in the midst of moving and it was generally chaotic, but he was just checked out, forgetting things, and generally out of it. On Tuesday morning, he woke up with red spots/lesions on his legs but nothing too alarming. Then, Tuesday evening, he started with a bad headache. He can't take any ibuprofen, Tylenol or the like because they are blood thinners. So, he just went to bed early and thought sleep would help. He was up several times during the night with his head, and at 5:45 am, he had a vomiting episode because of the pain. He slept for a bit after that and took a pain pill around 8 am. I called the transplant unit, and they said to bring him into the outpatient clinic. I told Parrish we needed to go in. I walked out of the room, and Parrish got up and walked into our bathroom where he collapsed on the floor. I ran in and got him up and sat him on the toilet. There, he started seizing. I screamed for my mom to call 911, and the paramedics where there in minutes. The seizure had stopped by that time but Parrish was not responsive. They checked his blood pressure, and it was 50 over 10. (Yes, you read that correctly.) And, he had a temperature of 102. As the paramedics started Parrish on IV fluids in our bathroom, I called the BMT clinic to let them know we were headed to UAB's emergency room. The paramedics carried Parrish out of the house on the stretcher and got us loaded in the ambulance. (As a side note, can you imagine what the neighbors thought? We haven't even been moved in for 48 hours and already someone is getting carried out on a stretcher?!)

At the ER, they took blood cultures and started Parrish on high dose antibiotics, in addition to continuing IV fluids. They took a chest x-ray and did a cat scan of his head (because of the seizure). The hematology/oncology folks and the BMT unit were in close contact trying to determine just what was going on. Once they got Parrish somewhat more stable, they admitted him to the BMT unit--the in-patient side of the unit. Once he got there, a team of doctors and nurses assessed him and decided they needed to remove the Hickman catheter (his IV line) in his chest. The line appeared red and inflamed and likely infected. The doctors removed the line last night, and as they did, they immediately saw pus. Clearly an infection. Throughout the evening, Parrish had continued fever, more vomiting, chills, and vacillating blood pressure. His oxygen levels also dropped, so they put him on oxygen.

This morning, all the blood cultures, taken from different spots, came back positive for a staph infection. We don't know exactly what kind of staph it is yet--it needs to grow on the cultures more. But, the line they removed last night had staph inside of it. So, they are also removing the medi-port that is under his skin (and was used for his chemotherapy treatments) because it is likely infected as well. That requires a surgery, so we are just waiting for them to come and get him for that. We don't have an exact time, but just as soon as they can work him into the schedule. He continues to have some fever, but the vomiting is better and his oxygen levels are better. His blood pressure seems to be normalizing as well. He still feels pretty crummy, though. In Parrish's words, he "feels like poop." Very clinical.

An infectious disease team is also now involved because of the sepsis and the seriousness of the infection. The doctors want to make sure that once they know exactly what kind of staph it is, that they treat it with the correct antibiotics. Until then, they are just using a trio of antibiotics to try and fight the infection. They will also do an echo of Parrish's heart to make sure the infection is not in his valves (they will either do an ultrasound or put a tube down his throat, that has not been determined yet). Depending on the type of staph we are dealing with, Parrish could be in the hospital for a while. And regardless, this infection will push the transplant date back. He'll have to be infection free for a while, get a new line placed and likely have more pre-transplant chemo because of the lapse in time. But, right now, no one here is even concerned about what this does to the transplant...they are just concerned about getting this infection under control.

Needless to say, the last 48 hours have been terrifying. And, after ten days of Ivey's stomach bug, 5 long days of moving and now this, we are all drained. I mean, a sick child can be a lot to deal with, a move is a major life event in and of itself, and a husband with a massive blood infection. Well, it is just too much to really even comprehend right now. Good thing I don't have time to process it.

Of course, there are things amidst all of this chaos to be thankful for. First, I am so, so, so thankful that the boys were not at home when we had to call 911. They had just left with our nanny to get out and about. I truly have no idea what I would have done if Ivey and Campbell had to witness that. I can barely go in my bathroom without re-living the scene. So, I can't imagine if they had been there. Thank goodness my mom was there and for all she did (and continues to do). And, thank God that the seizure didn't happen while we were en-route to the BMT clinic...and that he didn't fall down the stairs in our house...and that I didn't just let him keep sleeping. A lot to be thankful for. Not to mention my dear friends who met us at the ER, who went to our new house and unpacked all the remaining boxes, who stocked our refrigerator, pantry, laundry room and more. So, so, so much thanks.

But also, so much fear. These are the sorts of complications that remind all of us that no matter how well Parrish appears to be doing, he is still really sick. It is easy to forget that when you see him at work or with the boys or grabbing a beer with buddies. Most days, I think he just moves through the pain and sickness. He is a really good faker. But something like this totally knocks him off of his feet. And, yesterday morning was really, really scary. I can keep my sense of humor and positive attitude through a lot of things, but I'm having a very hard time mustering those right now.

Please pray that the doctors can get Parrish's infection under control and that he will start feeling better soon. That it won't mean an extended hospital stay. That the boys will be okay while he is gone. That we can all have the strength and energy to get through each day as it comes.

Much love,
Molly


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