Update - At The Hospital (4/19)

This post will be one of the most straightforward you'll see here...

Madelyn spiked a fever of 101.3 yesterday around noon. She wasn't quite herself, and with the fever we called the clinic and we went in around 1PM on 4/18. They accessed her port and took blood for cultures (determine if there is bacteria in her blood) and do a repeat CBC with differential and chemistry. With a fever >101, she would be admitted and given a broad spectrum antibiotic in leui of the cultures, where if some bacteria is found in her blood (bacteremia) then we could supplement with a specific antibiotic for the type of bacteria.

We stayed in the clinic until around 5:30 when we moved to room 1025. Madelyn was very tired yesterday. She ate normally, but still wasn't herself.

We had extensive conversations regarding the fact that Madelyn was not prescribed Neupogen (helps with white blood cell creation post chemo). Her WBC count yesterday was 0.3. Her counts are lower than ever. From now on, it is pretty clear that we will use Neupogen to support her immune system from here on out whenever she has chemo. I could rant about this for days, but I'll stop there.

She had her 2nd dose of IV antibiotics at 10PM and went to bed. She had a restless night and was up a couple of times for extended periods. SHe also had Neupogen IV last night and will continue to receive it in the evenings.

She does not have a fever now. Her blood cultures are negative so far (we have to let them grow for a few days to be sure). Her WBC count was up to 1.0 this morning. Her hemoglobin is lower than it has been, which points to why she is probably tired.

We'll be in the hospital until we meet some criteria:

1. Afebrile (without fever) for 2 days
2. Negative blood cultures for 2 days
3. Generally improved behavior and appearance
4. Blood counts that would not leave her in a severely compromised situation

The good news is that this may happen as soon as Friday. She has no fever, the cultures are negative thus far, she is playing and having fun, and her counts are slowly coming up.

I have to go now. Please keep us in your thoughts and prayers.

The Bell Family