Back to the ER

We had a great week at home with Sam. He was smiley and comfortable; he was sleeping and nursing well; his ANC (a measure of his risk for infection) was normal rather than depressed, as it was for much of his hospital stay; Tuesday's labs were good, and Thursday's spinal tap drew nothing but crystal-clear spinal fluid; we were told that there are a half-dozen solid marrow donor candidates in the pipeline.

Ambushed by Mr. Duck, the wash mitt.

But a day or two after he was fully weaned from Ativan and Methadone, Sam got fussy. And then really fussy--he could hardly be touched or moved without exploding into shrieks the volume and ear-piercing qualities of which had never before been heard. He refused to eat, and his temperature was a little elevated. (Yesterday morning he was in the low 99s--not quite to the 99.5 threshold they set for us, but well above the mid-97s he'd had all week.)

At Hematology's suggestion, we went to the ER and, with the All-Powerful Red Priority Badge in hand, went right to the front of the triage line (which would have been really satisfying if anybody else had actually been in it). We ultimately spent eight long hours in the ER, getting tests and trying mostly in vain to comfort Sam while ER and hematology staff conferred.

Proper children's hospital ER decor: assorted crayons, random Nat'l Geo map, box of condoms

Early diagnosis: withdrawal. Treatment: a dose of Ativan and admission to the Hematology unit last night*.

Sam's mood (and willingness to feed) had mostly returned to normal by this morning, but he's still not entirely himself, and the diagnostic consensus that we thought we had last night in the ER seems to have dissipated up here in Hematology. As have some of the soothing effects of last night's Ativan squirt. Which means we don't know how long we'll be here or how this is going to play out (e.g., if they'll put him back on Ativan or, if so, what a new wean protocol would look like).

Fortunately, there are no signs of infection or any other potential problems. Still, it's frustrating that poor Sam is stuck in (a rather unpleasant) limbo while the hospital decides what the problem is and what to do about it.

Feeling better this morning

* much to the pleasure--properly qualified of course--of some of the nurses here, many of whom have come to adore Sam