Tuesday, October 8, 2013

MRI and Fever #2

The moment of truth has arrived. Time for Logan's first MRI since starting chemo. This is where we will learn if the chemo is working and what the plan is moving forward.

Crazy eyes
This MRI was pretty standard compared to all the others. Out of the house at 5:30am to get to the hospital. Most people would probably cringe at being out of the house with a 3 year old so early, but considering he can't eat or drink anything, the earlier we can get it over with the better. We arrive at the neuro-ophthalmologist at 6:15 for eye drops to dilate his pupils. Whenever Logan gets an MRI, he get a retinal scan as well. This is part of a study that his neuro-ophthalmologist is doing to find more efficient and less invasive ways to monitor optic nerve tumors. We are happy to help the development of diagnosis/treatment in whatever way we can. 

By 6:30 we are checked in to radiology and on with the vitals and safety checklists. Really no different than any other MRI, other than to report that Logan is on chemo and has a Portacath implanted. 

Up until this point, Logan is his usual charming and energetic self. (I even got compliments when the MRI follow-up call came the next morning, about how they were all saying how pleasant and wonderful he was.) As with all other MRIs, this is when the crank starts to kick in as he is tired and thirsty.  Just in time to be put under.  In the past, Logan runs into the sedation room happily greeting all the doctors.  He is definitely getting wise to the terror of going under. One look at the sedation room and Logan took off screaming in the other direction. There's no fooling him any more. Thankfully, it's only a few short moments before he has a gas mask on and he drifts away. As many times as we do this (this was his 5th MRI), it is never easier to hold your screaming baby while he drifts to unconsciousness. The look in his eyes is enough to break anyone's heart. I will never be able to erase this look from my memory. From there they put in an IV and fully sedate him and get the scans started. From this point it is about an hour wait.

Everything was pretty standard.  Nothing exciting to report.  Waited for an hour, then joined him in recovery, where he slept for about another 30 minutes.  Once he was up, he had his juice and popsicle and we headed home. We should be getting a follow up call next day with the results. Once home it was time for a nap, lunch and another nap. Or so we thought.

After lunch, Ryan noticed Logan started to feel warm.  He took his temperature and sure enough Logan had a low grade fever.  As instructed, we called the clinic.  We were told if it hits 101 or is low grade for at least an hour, to go ahead and take him in.  Since this was happening in the afternoon, I got very excited about the possibility of taking him to the clinic instead of the ER but my bubble was quickly burst when the nurse told me that they stop taking sick patients at the clinic at 3:00PM.  It was already 2:00PM, not going to make.  We monitored his temp for the next 30 minutes, and sure enough, 101.7.  He headed to the local ER (about a mile from our house). 

We checked in at 3:00PM.  There was a lot of discussion about what they wanted to do and I kept telling them that they needed to call Logan's oncologist and follow their protocol.  This I expected, since we did not go to an ER directly associated with Logan's treating doctors.  What I didn't expect was the seemingly complete lack of knowledge of the process on their part.  In fairness to them, they are not a children's unit and probably don't deal with this on a regular basis.  By around 6:00PM, Logan's fever was up to 103.3 (which they wouldn't have known if I didn't ask them to retake his temperature, as they hadn't checked it since 3:00PM when we got there) and he was just getting some Tylenol to combat the fever and getting accessed. This access, was better than the last ER port access in that I had the time to put Logan's numbing cream on and it was far let traumatic on him.  On the other hand, they were clearly reading the directions of the port access as they went and they didn't adhere the to same strict precautions that I am used to seeing at Children's.   By 6:30, he was getting antibiotic. A process that I'm told is time sensitive, took more than 3.5 hours to accomplish. 
Fever baby

In addition, to the blood checks, and antibiotic, they took a chest x-ray to rule out pneumonia, a urine sample and strep test.  While I'm sure it's great they were trying to find a cause of the fever, I'm pretty sure this was just a way to rack up more charges.  Everything came back clear with the exception of the blood counts.  His counts were pretty low (as would be expected) but thankfully not low enough to require him to be admitted to the hospital.

All in all, in one day Logan spent 9 hours in 2 different hospitals and will go back for round two within 24 hours.  All of this during his first "break" from chemo.  We will definitely be taking him back to the children's hospital for round 2. 

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