An Update

Bumps in the road

Last Saturday and five days after his most recent round of chemotherapy, Noah seemed to be hitting full stride once again. He spent much of the day outside riding his bike, chasing after a hula-hoop, bouncing on the trampoline and walking a wagon of bottles over to the Lion's Club bottle drive. The weather was lovely and, after dinner, we had a nice fire over which we roasted marshmallows and hotdogs. Noah stuffed two of the latter down his gullet in quick succession. He was past almost all of the nausea and icky-ness of the chemo.

But Saturday night, as had happened the previous two, Noah woke up with pain in his tummy. On the first night this happened we assumed that he was feeling a bit unwell from the nausea or that his stomach might be cramping as a result of his digestion system re-engaging with his increased appetite and consumption.

However, Saturday night he was in much more pain than he had been the previous two. And the complaints had expanded to include areas beyond his tummy. He was, once again, pointing to his chest. And kicking his legs. And waking up every twenty minutes.

The flashbacks to last December, of course, were very real and that this pain looked so similar to his pre-diagnosis pain caused more than just a little panic in both Kim and I. I won't go on to expand the implications of such a re-occurrence as my creative mind has spend far more time there than I care to dwell on.

The line between hope and despair can sometimes be razor thin, even though the realities of each seem great oceans apart.

Back at the hospital

So, first thing on Sunday morning we called up the oncologist and took Noah back to the emergency department at McMaster. Noah was given a proper work up. They took blood samples and urine samples, they took x-rays and completed an ultrasound.

The oncologist consulted with Kim and, by mid-day, there was a pretty reasonable, non-worst-case-scenario diagnosis for what was ailing little Noah. Mucositis.

And what is mucositis? It is sores and inflammation on and of the gastrointestinal tract and it is a side effect of the chemotherapy drugs Noah received. Though no sores were visible in his mouth, Noah was feeling the pain up and down his throat and who knows how far beyond into his little digestive system.

And though his symptoms didn't really pop up until the night time, he was probably feeling uncomfortable for the few days leading up to his re-admission. But, because he was at home and wanted to have fun, he powered through any pain he was experiencing. Kids are incredible.

After finally getting the negative Covid test results, almost twenty hours after being admitted into the emergency department, Noah was moved up to the oncology ward once again. And as Kim always says when Noah isn't doing well, it is nice to be back on the ward.

Noah has continued to be pretty sick. His neutrophils had finally hit zero by Sunday (another reason he was feeling a bit better last week after chemo was that they had yet to tank) and they have not yet begun to tick upwards. Noah has not been able to eat and so he is getting nutrition through his NG tube. He has also been getting constant morphine infusions since Sunday so that he does not feel too much of the pain caused by the mucositis. This initially led to a bit of constipation but, thankfully, most of that has passed.

Tuesday, because of the inflammation and because of his complete lack of immunity, Noah began to run a fever. This had been expected and so our favourite guy was put on a couple more anti-biotics to help his little body combat that additional issue as well.

Right now

As of this writing, the fever seems to have gone away. He is still tired and sore and he can still be a bit ornery about everything. He is remains neutropenic and he will likely be in the hospital over the weekend.

His spirits, however, are pretty good. Though not running people ragged with his trike riding, he is beginning to perk up. His white blood cell counts were just starting to come back up this morning. We are hopeful that the neutrophils will follow and that, once back on the scene, these blood cells will work to clear up all the nasty bits of sickness in Noah's body so that he can come back home to wait for his surgery.

Which, of course, is still looming ahead. One "fortunate" (I use the term very loosely) part about Noah being at the hospital is that we have been able to cut out a few extra trips to McMaster by having his pre-operative scans during his current stay. Tomorrow, Noah will have both his CT scan and MRI completed back to back, requiring only one sedation. And while they are at it, they will do all of the necessary dressing changes that are so unpleasant for Noah when he is awake. It's the kind of consolidation a wise, former employer of mine would be proud of.

From there we'll just have to wait until our little boy is no longer sick in body and is merely sick of being in the hospital. When he is given the green light to return home I'll be sure to update.