Sunday morning dawned bright and early, with the typical Christmas hangover. The boys all had too much stuff and attention spans too short to play with any of it. So while they haggled with each other about whose stuff was better, I walked over to the hospital to listen to morning rounds.
Capt Snuggles apparently has more tricks up his diaper.
He seemed to be doing well. He’d had a quiet night, the Chaperones were quite pleased with him. Then I saw it. The telltale signs of blood in his diaper. I opened his diaper and it was just full of bright red bloody poop. The Chaperone informed me that he hadn’t pooped in 24 hours and his NG tube was putting out a lot more stomach juice than usual.
Christmas is over and so is the honeymoon.
That earned him a CT scan to rule out any blockages in his intestines. He has GVHD in his intestines. It causes them to become thick and swollen and difficult for things to pass. Since he’s gone from pooping almost every hour of the day to just once in 24 hours and bloody on top of it – there’s much cause for concern.
We end up waiting most of the day for the scan – Sunday afternoon turned out to be a busy time in the ER – several trauma’s came in, putting us at the bottom of the list. During the wait, he has another, not quite as bloody stool and his NG output is still copious.
By evening, we have results – everything looks pretty much the same as the previous scan. No obstructions (good). No air in the intestines (not so good). They are thick and fluid filled. It’s good news that there is no obstruction, but we still don’t know what’s causing the bloody stool and the increased NG output.
He is a riddle, wrapped in a mystery, inside an enigma. Thanks, Winston Churchill. Perhaps there is a key, we just can’t seem to find it.
Monday went quietly, no more poop, bloody or otherwise. They have managed to go down some on his pain meds/sedation. They’ve also gone down on his ventilator settings, in preparation of extubation sometime next week. His lungs are still pretty weak. Weak from being on the ventilator and having excessive fluid in his lungs, not from any issues inherent in his lungs.
And his skin continues to look absolutely amazing. Every day people stop by and gush about how awesome he’s looking. It’s good, it is. But now the real work begins, to get his insides working as well as his skin looks.
It’s going to be a long, long road.
Whew. And I’m already tired. I think exhaustion has finally caught up with me. Monday morning, I was so tired, I went back to the RMHC and slept. And slept. And then slept a little bit more.
Tuesday morning I woke up and I swear I could have went back to sleep for another few hours. But morning rounds were waiting for me.
I went back over to the hospital. He still hadn’t pooped and his NG output was still significant. His skin continues to be awesome.
He didn’t have another poop until about 3pm Tuesday and it was a repeat of Sunday mornings, bloody. Overnight into Wednesday morning, he had a total of 4 more bloody stools and his NG output is higher than it’s ever been.
On top of ALL of this, his lymphocytes are increasing. While they are not super high, they are elevated enough to determine that 50% of them are T-cells.
T-cells are not our friends.
They ordered a more in-depth blood test to determine if the T-cells are naive (his own) or activated (most likely from the graft).
So we’ll wait.
Maybe I’ll go take another nap while we’re waiting, I sure am tired.