Thursday, March 22, 2007
Well...we may have an idea of what is causing the fevers. A bacteria has been found in some of the cultures taken from Caleb's central line. In kiddos with an immune system this bacteria normally wouldn't cause an infection, however, this may be what is causing Caleb's 102 plus temps. So they have him on some pretty strong intravenous meds to try to fight this infection so he doesn't have to get the line replaced.
Also, Caleb has developed a pretty persistent cough and sneeze along with his congestion. We are hoping this doesn't progress into anything else. The concern with immunosuppresed kiddos is a 'silent pneumonia'. His SATs (saturated oxygen levels) are still looking good, knock on wood. If the SATs were low and would not be able to come back up that would necessitate a ventilator which a lot of immunosuppressed kids are on before and post transplant until their immune system starts to function somewhat. So we are praying that this does not develop into anything.
Caleb has also had a higher heart rate than normal when sleeping. They are trying to manage this through boluses (larger fluid amounts via IV). But his diarrhea is pretty frequent so it is a heart thing to be managed. If it continues they may to an Echo tomorrow to make sure his heart is okay.
His shunt was turned down, so it will drain a little quicker, to help his ventricles drain a little more. The neurosurgeons here do have some concerns regarding the shunt around transplant because before Caleb has his transplant he will go to the ICU for 3 days before the transplant to have an IV infusion to completely knock out his immune system. This infusion can drop the platelet count which in turn if not managed well can cause a bleeding risk in the brain. Therefore, we will have neurosurgeons (colleges of Caleb's doctor here at Children's)at Duke watching him closely so hopefully this will not be an issue.
As far as updates, this is all I have for now, please keep Caleb in your prayers.