Croup

I was told by two of my most amazing friends on Wednesday that I was required to blog yesterday. I suppose it really has been too long. 10 days now. In all fairness, nothing really happened until Tuesday night, so I'm not that far behind. I started this post yesterday, but Matthew was really not feeling well, and needed some extra attention.

Matthew's first week of break was fine. You could tell the methotrexate was getting to him. It makes sense - it was the highest dose of IV methotrexate he ever received. He got a little nauseous 2 days later, which is rare for him. One blessing for us is that the chemo never really made him sick, except the doxorubicin. So, the little bit of nausea wasn't that big of a deal. He had a little bit of pain that day too. All of the above was very manageable, though.

You can also tell when the chemo wears off. He has more energy, and wants to play. He's tired of being cooped up in the house. I can't wait to get him involved in SOMETHING, whether it be play groups, pre-school, head start, or all of the above! He cried this morning because he wants to go back to school so bad. (We used to call his daycare 'school') All I could really tell him is that some sicknesses go away pretty fast, like when you have a cold, but cancer takes a really long time to fight. Poor kid.

He's starting to understand the depth of it. He asks about death more than I know what to do with. I need to facilitate a conversation with him and Rachelle, the child life expert at the clinic, about it. She always finds amazing ways to help him deal with the emotional struggles he's facing. It breaks my heart that I have to teach my four year old about death because he understands that he is facing his own mortality. I've been a mother for 17 years, and this is totally uncharted territory.

Tuesday, things got particularly rough. He has had low-grade fevers pretty much every day for about a month, now. Ranging from 99.5 up to 100.5. As long as they stay below 101, and they don't stay above 100.4 for more than an hour, we aren't supposed to worry about them. That's easier said than done, though. It reminds me too much of the month before he was diagnosed. I brings scary thoughts about what's happening right now to mind. But they check his blood every week, and his doctor said the fevers are now, and probably also were then, just an indication that his body is working hard.

Well, Tuesday, his fevers stayed above 100 more often than not, but never went high enough for long enough to take him in. He also started sneezing quite a bit, and had a runny nose, but it was clear, which still means no infection. We were sort of on alert, but still didn't need to take him in. Wednesday morning at about 2am, Matthew came to the bottom of the stairs with a croupy cough.

I've dealt with croup with every, single one of my children. Many times. I've only been scared by it once before, and that was the first time Alaina had it. The sound of that cough can be scary. But with Matthew, it wasn't the sound of the cough that scared me, it was the way he was breathing in-between coughs. He couldn't draw a full breath. He was struggling to breathe at all. He looked pale, and terrified. It scared me. A lot.

Thankfully, my husband is amazing, and keeps his head during an emergency. He took Matthew into a steamy bathroom while I called the on call oncologist. She said to take him to the ER. Then a couple of minutes later, she called back to say that, based on his current good counts, if we could get the breathing under control, we could wait till morning. But, after 10 minutes or so in the steamy bathroom, he was still having a hard time, so we got dressed and went to PCMC. It was an icy snowstorm out there, and awful to drive in. Once again, I thank heavens for my amazing husband, who can drive fairly fast safely in the snow and ice.

Going out into the cold air also helped improve Matthew's breathing, but still not enough. By the time we got to PCMC, he was no longer struggling, but was still breathing fast and wheezing.

They confirmed that he has croup, and explained that it causes the windpipe to swell. In an adult, that wouldn't be such a big deal, because our windpipe is proportionately larger than a child's, but young children can struggle to breathe when they have croup. So, they gave him steroids to decrease the swelling. And we all know how much we love steroids in this house.

I have to say, though, never before have I seen so quickly what a miracle drug they are. It was the same exact drug he gets in his cancer treatment, Dexamethasone. Also a similar dose. And it resolved the situation almost immediately. They prescribed a second dose for the next night. He has had no more croupy cough and no more breathing issues. Just a dry cough during the day.

Thank heavens for modern medicine. And even though I loathe to say it, thank heavens for steroids.

I thought for sure, he was going to be admitted to the hospital. I was so relieved when they sent us home.

The most interesting thing about this ER visit was the doctor. I knew that I recognized him, but I couldn't place him. You could tell he was also trying to place us. Justin is the one who knew - and I think he knew from the beginning. This is the doctor who saw Matthew in the same early morning hours on July 12, 2011. Matthew had been sick with an infection in a salivary gland in his cheek and had swollen lymph nodes down his neck for a month with an accompanying fever. This doctor was the first person to tell us he thought our son had Leukemia. He drew us a picture of a bone on a paper towel, and explained what the different types of blood do, and why it was such a problem that Matthew had no neutrophils. He admitted Matthew to the ICS for further testing based on the fact that he had an ANC of 0.

What a weird, full circle moment to happen during the week before Matthew was to begin Maintenance.

He was really nice, as he was the first time. He was glad Matthew was doing well. It was good to tell him he was right, because Matthew didn't present like a normal Leukemia patient, and this doctor took a chance and went with his gut to find us an answer. I have always been grateful for him.

After we went home, it took us a full day to catch up on the missed sleep. Then another day for Matthew to get over the emotional side-effects of the steroids. But now, all that's left is some dry coughing during the day. Certainly not the disaster it felt like in the middle of the night on Wednesday morning.

Monday's lab results:

White Blood Count: 2.7
Hematocrit: 32.1
Platelets: 261
ANC: 1290 (They went UP from last week - and we fully expected him to be neutropenic for a few weeks!)

He's such a rock star.