And Now for a Sprained Ankle

Katie recovered well from her Thrush. The Fluconozole cleared it right up. She was feeling good, eating well and getting lots of sleep in the days leading up to her last dose. So, we planned a sledding trip for the upcoming weekend. It was a disaster.

The trip started early Saturday morning. I wanted to get everyone on the hill early while the snow was still icy and fast. Temperatures have been climbing into the 40's during the day lately, and after a few hours of sunlight, the snow turns into slush. But first thing in the morning, it is compact and icy enough to walk on. I chauffeured the family to a hill just a few miles from the house where Amy would start at the top of the hill with the kids and I would wait for them at the bottom. The problem turned out to be that the snow was exactly as fast as I had hoped it would be.

Katie eagerly volunteered to go first. She hopped into her sled and headed for the bottom. Before long she was a little rocket flying down the hill and we could already see the potential for an accident as her sled began veering off the planned course and towards trees and bushes 50 feet off to the side. She was too far up the hill for me to get to in time and she was already too far down the hill for her mother to get to her in time. As I ran up the hill, I hollered to her to turn or roll out of the sled. She sat frozen, not knowing how to prevent the imminent crash and not daring to roll out of the fast moving sled.

As I watched, her sled plowed over the first few small bushes protruding from the snow and started to turn back in the right direction. For just a second, I hoped that she would actually make it through without crashing. Then her sled hit one bush too many end for end, ejecting Katie and sending her through the air for another three or four feet before she touched the ground again. When she hit the ground, she hit standing up and drove one foot into the compact, frozen snow. The rest of her body still had enough momentum to keep tumbling even as that foot tried to stay lodged in the snow. It eventually came loose and she tumbled a couple more times and slid to a stop on her face, already crying out in pain.

I thought she had broken her leg for sure, especially considering how easily she had broken her foot last summer. I quickly established that the only thing that hurt was her leg, and then I carefully took her boot off. Amy had arrived by now and we looked over Katie's leg carefully expecting to see very visible signs of a break. There were none, but Katie was certainly in pain. We took her back to the house to keep an eye on her and wait for the swelling. We didn't wait long. Within fifteen minutes we were on the way to the hospital, Katie sitting in her car seat with her leg carefully propped up on a box and using my coat for padding. To our great surprise, the x-ray showed no broken bones and Katie was sent home with an air cast to provide some support and a little protection.

This all happened five days ago, and Katie still can not bear weight on that foot. She has been at school every day this week, but when it comes time to move from one room to the next, her teacher carries her. When she just has to move around inside the classroom, she crawls. We still have the walker that she was given back when her neuropathy was so bad that she couldn't walk at all, but she refuses to use it. She says that hopping behind the walker hurts and she would rather crawl.

Her spirits are good and she is adapting well to her new limitations, but I sure do wish she didn't have to adapt. Whenever she tells the story, she is quick to point out that the whole trip was her "Daddy's idea" so her sprained ankle is "Daddy's fault". I have to agree. Next winter, we will choose a smaller hill.

Our Plans Changed in an Instant

In the last post I wrote that Katie was feeling good and was looking forward to a vacation of rest a play. We were even planning a trip to the mountain for a little skiing. That didn't happen. The night that I wrote that post, Katie became ill and was vomiting from 3am on. By 9am the next morning, she had a fever of 104.3 and we were off to the hospital. Our first stop was North Country Hospital where her blood counts revealed some serious underlying problems. Her total white blood count was .2 or 200, her ANC was nonexistent, and her hemoglobin was 7.4. Everything else was just as low. She was then loaded into an ambulance and sent to Fletcher Allen for further treatment.

Once at Fletcher Allen, Katie recieved mega-doses of antibiotics just in case, and a transfusion to get her numbers up and out of the dangerously low levels to which they had dropped. She was also given simultaneous doses of tylenol and ibuprofen to stop the fever from rising any higher. It hadn't responded to a dose of only tylenol earlier. Katie was then kept at Fletcher Allen as an in patient in the children's hospital for the next two nights until she no longer had a fever and her blood counts seemed like they were rising on their own. She was released from the hospital today.

Katie is still neutropenic and not allowed to go anywhere without a mask on, but since her body seems to be recovering and no longer in need of the IV fluids or other maintenance drugs, she was allowed to leave the hospital and finish her recovery at home. We didn't actually take her home tonight though, instead choosing to stay in Burlington one more night with Katie's Grandpa Art and Grandma Kathy. We brought her here directly from the hospital and she immediately took a 3 hour nap. It is hard to sleep well in the hospital with nurses checking on you around the clock.

Tomorrow morning, we will actually head for home where Katie will be allowed to spend the next couple of days until returning back to Fletcher Allen for a follow-up and her first half-strength doses of chemotherapy again.

Emergency Room Update

The doctor just came in to tell us what Katie's blood count is. Its low. Her white blood count is just 1.1 and her absolute neutrophil count is only 770. Her numbers have suffered a precipitous drop over the last four days. Considering an ANC of 500 will put her back in the hospital for days, we are a little worried about this. Also, given the number of illnesses floating around our house lately, a dropping ANC does not inspire hope of a healthy near future.

I'm also going to write down her basic number here so that we don't forget them...
ANC 770
WBC 1.1
HemoGlobin 8.1

So Much for Getting Well

That cough that we mentioned in our last post has progressed in to something that sounds croupy, the ear infections never did go away with that last dose of Amoxicillin,  and we are back in the hospital. This time, we are at North Country Hospital with a fever of 103.2. Katie is feeling awful, but dealing with it well as usual.

Port access went very smoothly. North Country doesn't stock the types of access needles that Fletcher Allen uses with Katie's port so access has historically been difficult here. However, at our last visit to Fletcher Allen we were given several access needles to keep with us in case Katie needed to have her port accessed again at North Country. The nurse used one of the Fletcher Allen needles today and accessed Katie's port with great ease. It made a real difference.

The plan for right now at least is to wait for the results of a blood count, wait for the Ceftriaxone to finishing dripping through her IV, get some medication for her recurrent ear infections and go back home. Hopefully, this will be just another routine visit to the hospital.

Chemo and Ear Infections

Overall, things are still going smoothly for Katie. She has only had to contend with minor incidents in the last few weeks. She had another ear infection a couple of weeks back that gave her enough of a fever to put in the emergency room at North Country Hospital for an afternoon. Her port access went smoothly and she was in at 1pm and out by 5pm. That's the kind of quick trip to the ER and back that we like.

This past Friday, she traveled to Fletcher Allen again for another round of chemotherapy. The last few monthly doses haven't had much of an effect on her other than to make her tired and a little ill - nothing that disrupted her activities. This dose of chemo had a more apparent effect. The Vincristine made her feel nauseous for the first time in a long time and she made several trips from her bed to the bathroom last night to get sick. I figured that she would be too tired to go to school today, but she woke up bright and early, ready for another day. She was more ready than Amy and I.

This past Saturday, we bought her her first pair of downhill skis, boots, and bindings. Now that there is snow on the ground she is eager to try them out. If the promised nor'easter hits tonight and we get a snow day tomorrow, we'll have to let her break her skis in in the back yard. Maybe she'll even let her parents sleep in late...

A Cough, A Fever, and the Emergency Room

Katie was up most of the night last night with a barking cough that sounded an awful lot like a case of croup. This morning, she woke up exhausted but feeling a little better. We let her go to school but warned the school about her night and told them to call us immediately if she was tired or sick. She made it through the day just fine.

However, when she finally arrived home after traveling around with her mom after school doing errands, she had a fever. Amy walked through the door carrying her and said “Take her temperature”. The thermometer read 102.8 and we were quickly on the phone with her oncologist, and then on the way to the hospital.

Happily, despite thirty plus minutes and three attempts, at accessing her port, it was determined that there was nothing seriously wrong with Katie. She tested negative for the flu. Her ANC is fine and her other vitals are what they should be. The doctor did find a double ear infection though, and are wondering if that might be what spiked the fever. The doctor said that the infection wasn’t bad enough to treat except for the fact that Katie was running a fever so he would give us some antibiotics to be on the safe side.

Four hours after leaving the house, we returned and Katie is now sleeping soundly in my bed… I think I’ll squeeze into her bed again rather than waking her up just to move her across the hall. She could use several hours of undisturbed sleep.

More Than a Simple Fever

Katie was transported by ambulance from North Country Hospital yesterday afternoon to Fletcher Allen Hospital where she spent the night last night and will apparently be spending several more. Her fever came and went throughout the day yesterday, but more concerning than that is the fact that she still has pneumonia and a nasty ear infection even after 10 days on antibiotics that she was taking specifically to cure those two problems. In addition, her blood counts have dropped.

The initial blood tests yesterday indicated that her ANC was just 420 again, considerably lower than it has been since the last precipitous drop back in January. This morning's blood counts show that her ANC has dropped even further, down to just 280. Her platelet and hemoglobin numbers are also low, although I have forgotten the exact numbers already.

We don't know exactly what we are in for yet, but it is starting to look like Katie may be in the hospital for many more days. On a side note, yesterday, her first day in the hospital, was the first official day of our summer vacation.

An Ear Infection That Led to a Fever

Katie has been suffering with an ear infection since Friday and ear infections never bother her. We were unable to get her to her doctors Friday before they closed and we wanted to hold of on another ER visit. We kept her as comfortable as possible over the weekend on rotating doses of Tylenol and Motrin, but as of Monday morning, her temperature has climbed above 101 so we are ER bound.

I'll post more updates later in the day when we know what is going on. For now we are headed to North Country Hospital.