Tuesday, March 11, 2014

Mommy: Huh... well that was unexpected...

Today has gone a bit differently than we expected. First of all, despite not getting a very good night's sleep last night, Cambria didn't want to go down for her first nap (she's been in a schedule of 3 naps per day) So instead of  "Breakfast" and "Lunch" naps, she took a "Brunch" nap. Thankfully it was a good long 2 hour nap... because she didn't nap again until we were on our way to get her blood work done.

The other weird thing about this nap, was that when Derek went to get her, she had a bit of a shiner... now, random bruises and cuts are a fairly normal thing for Derek and I, and Cambria *does* like to play a bit rough (especially with the rungs of her crib) but with the chemo, "platelets" are instantly on your worry list. Otherwise she's been her normal, playful self... (other than a few extra rounds of diapers for poor Derek, and an extra large lunch of pureed chicken afterwards) Anywho, we were glad that she was already scheduled to get her blood work checked. 

So we left the house a couple of minutes before 2, and got to Children's about 2:30 (Yay for mid day traffic!) We got to see our nurse buddies, and luckily for Cambria, the waiting room was FULL of well kiddos playing and running around while their siblings were treated. Which, I also noticed a LOT of the temporary badges, and today was a Allergy clinic day (the allergy clinic shares the waiting room with the hemotology & oncology clinics) so it was a pretty cheerful room. Cambria had a BLAST watching the other kiddos... like highlight of the week!!! We're SO excited to take her to play groups, and swim classes, and story time at the library!!!!! 

But, first we had to get her blood work done. So we went back, and had our first surprise at the hospital. Cambria straight up screamed bloody murder at the poor lab tech. Thing is, she started crying before he even brought out the needle.... so at first we assumed that she's gotten old enough that she remembers what it means when someone starts poking at your arm... but then Derek pointed out that the lab tech was a man without facial hair!!!! Since sometime in October/November, the only men she's interacted with that didn't have facial hair, she cried at! Yes, the whole being tired of being poked with needles thing makes way more sense... but you never know... 0.o

So we headed back to the waiting room to wait again. See... we had thought this was a lab work appointment and a meeting with the doctor. It turns out, all we had on the books was a lab work appointment.... but when the nurse came out to tell us that we could go and they'd call us with the results, we pointed out the bruise, and then the nurse asked if we had seen any red little dots, and we showed the couple we saw on her face as well. So she agreed it would be good to wait, and she let the lab and her oncologist know we'd be waiting. 

Here's a pic of the little girl hanging out in the waiting room, complete with sad eyebrow bruise, and if you can squint real close you can see a few of the little red dots (the one on the nose is just her scratching herself):

So at about 3:45 or so, a nurse came out saying most of the counts were in, but the platelets said "pending" which means the automated counts came back low, so the technicians were doing it by hand. By this point, I had found a few more of these little red dots (which now I know are called petechiae) on her legs, so I showed these to the nurse as well.  She said that those, especially with the bruise, were pretty good signs that her platelets were low... we just don't know how low yet. So we (sort of) patiently waited until about 5:15 when Cambria's oncologist and nurse practitioner both came out to let us know the results:
  1. her ANC is a wonderful 1540, so they gave permission for quarantine to be lifted!!
  2. her hemoglobin was borderline... (7.0) they asked us if she had been extra sleepy or had a lowered appetite, or less active in her play, and since she was normal and/or exuberant on all of those subjects they decided against giving her a transplant, and just having us watch her for a drop in energy, appetite, playfulness and/or interest. If any of these occur, we'll take her back for another blood test.
  3. her platelets were low. 20,000. (which is their line for whether or not they automatically give platelets... like 20,000 is both the line, and her count) As she had the bruise, and a growing number of red spots (seriously, more showed up while we were waiting - it was really freaky) her oncologist ordered the platelets. 
*sigh* She was so close. To be quite clear, it is NORMAL for children on this protocol to get multiple transfusions and/or platelets. The fact that Cambria hasn't needed any blood products OR overnight stays is a HUGE blessing!!!!! Also, the fact that today was already scheduled  for her bloodwork was a gift. (Traditionally, this would have been a Wednesday appointment) But, as her platelets and hemoglobin have been good this whole time, we just weren't prepared for it.

So, once again we had to get Cambria accessed (which, as she was woken up from a nap to do it, and we didn't have the seahorse to distract her, she was in full meltdown mode during the procedure) then we were off to wait in a pod for some more bloodwork to come back so they could match the platelets with her blood type. Oh, and we got her vitals done... she's now 70cm long and 19lbs 2 oz. (Still growing like a weed!) 
Here's our girl waiting in the pod (not sure if it shows up or not, but she definitely had more spots by this point)

Finally, the platelets arrived, and we got her hooked up. Surprisingly the infusion itself only took about 15 minutes.... but then as we got her deaccessed, she took a long time to clot :-/ This made me especially heartbroken for her, as well as incredibly grateful her doctor made the call to get the platelets. Normally clotting from deacessing the port takes 2 or 3 seconds. This time it took 2 or 3 minutes. 

*sigh*

 So all in all, a very LONG day. We're SO glad her ANC is up though! And that her team at Children's were attentive and made sure she got what she needed!

Now it's time for us all to get some sleep. Hopefully Cambria sleeps better tonight and tomorrow than she did last night or yesterday!

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