We're Home

Feeling better, so we get to go home. It is surprising how grateful we can be to be home again! Although the hospital is a good place to receive medical care, it is not a good place to get sleep. I was too tired in the hospital to keep you up to date with the details but can now recap our experience over the last 5 days. Here is a quick review of the blood counts so you understand what I am talking about.
ANC = Neutrophils=Germ fighting cells
Hemoglobin (hgb) = Red Blood Cells
Platlets = Body's clotting ability
Bone marrow - Where these cells are made
The chemotherapy that Kate has been getting over the last 2 months has completely wiped out her counts - thus the need for a blood tranfusion last Thursday and platlet transfusion on Monday. After those 2 transfusions Kate's hgb was 11.8 and platlets were 147 which are nearly in the normal ranges. Her ANC was 70 which is very low as anything under 500 is considered immunocompromised. So this is why we ended up in the hospital when Kate developed a fever. The protocol is to give IV antibiotics until they grow the blood cultures and determine whether the fever is from a bacterial infection or a virus.
When we first arrived, our attending doctor told us that we would have to wait until after 48 hours of negative blood cultures and signs that her blood counts were recovering before we could be discharged. On Tuesday her ANC went down to 60 and hgb and platlets dropped too. On Wednesday the counts looked better with an ANC of 110 but still dropping hgb and platlets. We were hopeful that yesterday her counts would improve but they all dropped again and her ANC was 60, hgb 8.8 and platlets of 68. The fact that these counts were not increasing meant that her bone marrow hadn't recovered yet and wasn't producing the cells as needed. So, based on our conversation with the inpatient physician we were prepared to have to stay for at least another day or two.
We were so happy when the inpatient physician came in and told us that he had discussed the case with our regular oncologist, Dr. Keller, who thought that it would be ok if we went home despite the poor counts. Kate's fever was gone, she was looking great and we were just waiting to see improved numbers. His thought was that it could be a week or more before her counts improved and that we could do that at home. The one downside is that if she gets a fever we will be back in the hospital for another admission. Chant with me - no fever, high counts, no fever, high counts...
We will be going back to the clinic on Monday for repeat counts and to see if we will need any transfusions by then. For now, Kate is doing great. She is smiley, her spirits are up as usual and she has a lot more energy than you would expect for a girl with a hemoglobin of 8.8.
We are headed to Camp Sunshine Family Weekend today and tomorrow and are really looking forward to it. This is a camp for children with cancer and for their families. There is a physician on site and it is an hour outside of Atlanta so we should be safe should Kate develop any fever or other complication. We'll post some pictures when we get back!