Allergic Reaction

2/18/2012: 12:02 PM

It has been an eventful last couple of days.

Tuesday evening, Annakate was complaining of ear pain. We headed to the doctor's office on Wednesday (third one in three months), and an exam and throat culture later, we were told that Annakate had strep throat. I was surprised because she didn't have the classic systems that we were used to seeing: sore throat, fever, etc. Needless to say, Annakate was stuck at home for a couple of days until the antibiotic kicked in, and Davis was shipped off to Grandma and Grandpa Coffey's for the night. We have found that it is easier to send him away when Annakate is sick with something contagious. That gives her the freedom to leave her bedroom and me the time to clean and sterilize.

Annakate at the doctor's office. This sweet, little girl
doesn't look sick, does she?

Davis and I headed over to Sarah Bush to get his counts on Thursday. The Ara-C chemo that he was on the week prior really kicks the snot out of his blood counts. His white count had dropped to 0.4 (healthy kids are between 5 and 10) making his ANC (immune system count) 208 (healthy kids are above 1500), which means he is at a critical risk for infection (neutropenic) if he were to pick up a bacteria or virus. The ANC can fluctuate rather quickly. On Monday, his ANC was over 1600, and by Thursday, it was down to 208. Hopefully, it is on the climb again. We also found out that his platelets had dropped to 11 (healthy kids run between 150-450), so he was scheduled to have a platelet transfusion on Friday.

The plan in the clinic on Friday was to give Davis his platelet transfusion, his Vincristine (IV push chemo), his Peg shots, and them come home. Two hours max. Other than the Peg shot leg pain, it was supposed to be a pretty easy, routine chemo day.

You know, if it wasn't for the generosity of donors taking their time and undergoing the uncomfortableness of donating blood, my son (and so many other children fighting blood cancers and other types of cancer) would die. I know that sounds so blunt and drastic, but it is true. I think about how cliche the slogan "Donate blood. It saves lives." has become, but I have seen first hand how the anonymous blood donations of strangers has kept my son living. I know that I will continue to donate as long as I am physically able, and I will do it for Davis and the other children in similar situations who depend on it to survive.

Davis' platelets from the Red Cross

Davis was hooked up to his platelets. Occasionally, he has to be given Benadryl because sometimes platelets make him sneeze. Weird, huh. Davis' doctor was never convinced that it was a true allergy, but his nurse believed otherwise. I know it sounds crazy to be allergic to blood and platelet products. People aren't actually allergic to the blood or platelets. They are allergic to the antibodies that are found in the blood and platelets. Since every donor is different, there are different levels of antibodies in each unit of blood or platelets. And that can be problematic for some.

Beginning of the platelet transfusion. Platelet
transfusion #5 or #6, I think.

Davis received a platelet transfusion last Friday, and all was well.  There was no sneezing, no reaction of any kind. Yesterday was different. Ten minutes or so into his platelet transfusion, Davis began to sneeze and snot. We have seen this before (although an unusual allergic reaction to platelets), so we were not alarmed. The nurse ordered him some liquid Benadryl to take. After his first dose of Benadryl, the situation changed very quickly. Davis started complaining that his back was itching. The nurse and a nurse practitioner kept examining him. His blood pressure, temperature, and oxygen was monitored. By the time his second dose of Benadryl was taken (15-20 minutes later) and the platelet transfusion was suspended, Davis' lips and eyelids were swollen, and he could no longer speak (He had lost his voice). It was decided then that the allergic reaction was severe. Although his oxygen levels were still strong, the medical staff didn't want Davis to become anaphylatic. Davis received an epi-pen injection, medicated (albuteral) oxygen, and hydrocortisone via his port in a matter of minutes. To be honest, there was very little time to feel any emotions. Plus, the medical staff was so diligent; it appeared they had everything under control the entire time. After twenty minutes had passed, Davis was his old self again. In the future, Davis will be pre-medicated with Benadryl via his port before any platelet transfusion.

onset of swelling

examination and monitoring

suspension of platelets moments before epi-pen. You wouldn't believe
that there were four grown women hovering over him from
behind a curtain in this shot.

breathing treatment

The allergic reaction definitely took a huge chunk of time out of our day. He was given his Vincristine and Peg shots a while after his reaction. We had to wait another hour after the Peg shots to see if he was going to have an allergic reaction to them. Actually, the wait was a formality. Davis was so full of antihistamine blockers, there was no way he was going to have an allergic reaction to the Peg shots. For sure, he was pre-medicated for those. To the best of our knowledge, the Peg shots he received Friday are supposed to be his very last. Yay! The doctor was pretty sure there were no Peg shots in Maintenance; however, she is more familiar with the B-cell Leukemia roadmap than she is with the T-cell Leukemia roadmap, so she may have misspoken. Hopefully not.

There was still quite a bit of inflammation and swelling at the epi-pen injection site when we were free to go. We had to keep an eye on it and make sure it went away, and with time, it did. We finally made it back to Mattoon a little after 6 PM, three hours later than expected. Davis slept all the way home - a blessing from the Benadryl.

Visiting with friends. Our friends from Florida were home for the
weekend, and Davis seriously objected when we considered skipping our evening with them.
It makes sense now. What young man wouldn't want to keep these pretty little ladies company?

Davis is feeling a tad bit crummy this morning. No, that's mildly putting it. He is a grouch. I guess he has earned a little grouchiness. Hopefully, I can convince him a nap will help his mood. Next Friday will be Davis' last chemo treatment before the Maintenance Phase begins. He will have a week or two off from chemo in between the phases in order to let his counts build. The next phase cannot be started until his ANC is 750 and his platelets are 75 (built back on their own, no transfusions). I know the road ahead is still very long and difficult, but it brings me such joy to look back and see what success we have had beating cancer the last eight months.

God continues to keep His hand on Davis, and we continue to pray for complete healing and good health until his very last treatment and beyond. We feel so blessed.

We will keep you posted.