Coming along...fevers and chocolate

Tuesday June 23

Well yesterday was eventful after the orgasmic removal of the epidural. We walked, and Josh took a wondrous, glorious, spectacular, spashy shower. Waterwonder.

The pain team gave Joshua control of the oxymorphone dosing, to see how it went over the course of the day. The idea was to establish how much opiate-like substance he would need, in order to change to oral meds.

I was rather leery of this approach since it seemed to me that while the toradol was spectacularly effective,

1. The oxymorphone was not working well at all, (and that maybe it was responsible for the fevers…which may or may not be the case, of course. Except that Daniel ALWAYS has a bad reaction to opiates…and, I can’t tell whether this family information crosses over the pain management team’s threshold for “worth consideration” but they don’t seem to acknowledge this as a possibility. Maybe it’s not worth much. Or maybe it is?)

and

2. I was pretty sure that by the time the situation was clear enough, that the pain management’s A-team would be long gone, and only the lonely, nighttime responders would be left in the hospital. There was nothing to do but go along for the ride...And....

Josh texted me at 1:30 AM to say he was in a lot of pain and had a high fever. I decided to give a call to the head nurse about ‘can we have closer attention from the pain team? And a plan in place by EARLY morning instead of waiting for them to arrive later in the day?’

Josh called in the AM to report he was going for a CT to find out why the fever, and that if they found gunk in his abdomen he might be in interventional radiology when I got there. I took the morning off with Daniel, walked Manhattan, breathed perfectly humidified comforting air.

Josh was back from the CT when we arrived: the initial read, of course is “fine” (which is, I think, the trained response of anyone working in radiology whether it’s “fine,” or not) but we were informed at 6 PM that he has pneumonia, and “just a little effusion…” His white count is up to 14 or 15.

So no interventional needles were needed at the moment, the abdomen so far looks good (Yay) and he’s on IV and the pain team HAS changed him to morphine, early in the AM, which DEFINITELY is better from the looks of him. 

 

So that 1:30 AM call was either effective, or redundant, but I am grateful that the pain team made the change EARLY and that Josh is more comfortable and that they have made tweaks thoughout the day. He was definitely more peppy—or is it antic? or fidgety?-- all day—(the antibiotics? the morphine? the recovery? is he sick?)—and his MDs are happy with his progress. He was lapping the floors, asking for this and that, and able to look around him, hold a conversation, and plead for food, back scratches, foot rubs, hand holding, head massages, more food, different food, other food. And, he’s not into kibbles: only wet food. The mouth is really dry.

“Bring pastries! Lemon or almond”

“More water!”

“Odwalla protein smoothie but not that kind you brought yesterday it was too thick, but OK, if you can’t find anything else we’ll water it down!”

“Chicken but not dry chicken. Juicy chicken.”

Meanwhile, he hardly eats much at all. Two Cherries, a couple of grapes. Banana. Lots of water.

 

Wednesday

AM: Joshua took ten laps around the floor. Almost a mile. Midday, Joshua looks pasty and lethargic. He is cold and pouring sweat. Not in pain. But feeling lousy. WBC is 29-30. The antibiotics are not doing the trick. More tests: the port, the urine, the blood, the nose. Nothing is certain about what is happening right now… The pain meds are now oral, working fine, and they are going to decrease the dose. He still has the IV for rescue but he’s not pushing the button for pain meds, so that’s a good sign that the orals are working…

It’s evening now, Daniel and I bring Josh a warm chocolate cake with caramel sauce and a crepe filled with hazelnut sauce and fig ice cream. This is the first enthusiastic “meal” he has eaten and every last lick was enjoyed with rolling eyeballs and grunts and moans. This could be called “confectionary color change” as he turns from pale to rosy, really wakes up, and (wonder of wonders….has a productive trip to the bathroom!) He is now out walking, looking pretty spunky and I hear him chatting away with Daniel.

Anyway, if you are contemplating visiting please evaluate the possibility you might infect him or carry infection from him to your loved ones… I repeat: he has pneumonia and an uncontrolled fever with rising white blood cells. So have you been touching children who are notorious carriers? Have a cough you think is “allergies?” Been tumbling in the park picking up cruft? Cleaning your shoes? We would be appreciative if you would become NEUROTIC about hygiene  before you plan a visit, and wait a bit. It will be better for everyone involved if you will be patient. Thank you.

 

And you people praying out there? Whatever you’ve been doing has been much appreciated, and please keep up the good work: we are not out of the woods yet. (Isn’t that a strange turn of phrase? As if the trees and the wolves are more dangerous than hospitals...anyway, we are grateful for the trees the wolves AND all who work in hospitals, equally, as they hold us on this earth)