ER Visit

1/2/2010 Saturday

We came home this afternoon from a 5 hour stint in Children’s Hospital ER. There was NO emergency so you can breathe a little easier! We woke up and made an appt. to take Liam to his 3rd finger stick of the week. Right before leaving we changed his diaper and saw that the area where his peri-rectal abscess had been was red and the incision site from his surgery looked like a wet scab. (It has been fine up until today).

We took him for the finger stick anyhow, thinking we’d give his bottom a little time to get better in case it was just irritated from poop. We checked his bottom as we were ready to leave our normal clinic and decided it looked the same.

Our only option today was to take him right to the ER since the Hem/Onc clinic is closed on the weekends. We knew that any sign of infection is VERY serious for someone with low or no neutrophils. We were very lucky when we arrived because they were not busy and we got right in. We saw a few doctors who agreed that our concerns were very valid. They ended up deciding that Liam’s abscess is infected again, but that we caught it extremely early. The actual infection seemed to be the size of a pea. Otherwise he looked VERY healthy to everyone there. He has been in a great mood today and was acting like himself!

We got a surprise as our regular pediatrician came into our ER room. It turned out that he was at the ER for his own granddaughter and found out we were there as well so he came to say hi and check on William. Then our own Hematologist who has been treating Liam since he was staying in the hospital happened to be the one on call so she came to see Liam. We were really happy that she could come and sort of take over his treatment. (Not that the other Dr.’s weren’t doing a great job, but she has been through everything else with us and it was good to have her help make the important care decisions).

She said that his ANC (Absolute Neutrophil Count) was around 150 today. It was nice to hear that they had gone up from 0 on Wednesday but the change is not that significant when dealing with infection. We had a few options to consider. We ended up agreeing to I.V. antibiotics in the ER today with an I.V. dose of GCSF (Granulocyte Stimulation Factor) which helps to raise his Neutrophil count. Liam needed I.V. antibiotics to hit the infection hard, and they decided that since he was looking so healthy otherwise, he did not have to be admitted and stay in the hospital. He got those 2 I.V. doses and then a prescription for an oral antibiotic for the next 10 days.

We were a little bummed to have to give the GCSF because synthetically raising his neutrophil count will now mess with our attempts to see a general baseline of Liam’s natural neutrophil levels. (Our 6 weeks of pricking his finger 3x a week will now be stretched out even longer). We decided it was important to give the GCSF despite that issue because we wanted to get him healthy ASAP.

Now because the GCSF raises his Neutrophils, it could actually make the abscess worsen before it gets better. Sounds crazy, but as your body makes more puss cells (Neutrophils) it will start to act as a normal body would and make the infection site swell, get redder and make puss. We will need to watch this to see if he will have to have the abscess drained again like he did in the hospital. (Hopefuly NOT!)

We will have to bring Liam back to the ER tomorrow for his second dose of GCSF which should be just a quick check of his abscess and then a shot. Then we will take him into the Hem/Onc clinic on Monday for a check in and a third dose of GCSF. We will then talk about if we should continue the GCSF or take a break to continue watching his typical levels.

Now we have to think happy thoughts about William getting past this infection quickly. We handled everything well today, especially the little man who just whimpered when they put in the IV and was a perfect angel the rest of the time. He even flirted and smiled at the nurses after they finished poking him! He played a few mean games of Peek-A-Boo today and started to push up on his knees in our bed this morning. We just want him to have time to be a normal boy so he can catch up on things like learning to crawl.

I don’t want to jinx ourselves but he has only been waking up 1x per night in the last few nights so hopefully we are on track to good nights of sleep again!

Thanks to all of you who are keeping tabs on us. It’s nice to hear that many of you are interested in our story and are praying or thinking about us. We wish you all the best!
Love,
~The Moeller’s