what else can go wrong

Ethan's last round of chemo was straight forward. Despite a bit of nausea and anorexia there were no major complications. The naso feeds were continuing so the feeding issues were under control. He was discharged on Sunday with the plan to be admitted Tuesday for day chemo. In the short time we were home he managed to vomit the tube out a couple of times. The main issue being weight loss.

He was admitted for day chemo as planned. He was given the thorough once over. He had lost a fair bit of weight so the nausea medication was increased.

The plan from here was to be home for a couple of weeks before the next round of chemo. Both girls had fevers and we knew Ethan would be next. On Wednesday he was still vomiting and was starting to look unwell. His bags were packed in case we had to do the midnight run but this didn't happen. He manage to have low grade temperatures at home until Friday before it was decided by the oncology team to take him back for a review. He was admitted with an upper respiratory infection and febrile neutropenia. His port was accessed and antibiotics commenced. His oxygen levels were 70% and oxygen was also started. On Saturday he started having diarrhea, the temperatures were getting worse, and his counts had dropped. A platelet and blood transfusion were given and his naso feeds changed to gastrolyte. His oxygen requirements were also getting higher. The nurses and doctors were keeping a close eye on him.

On Sunday morning his port site was looking a little redder. Nothing bad but enough to keep an eye on and add in another antibiotic. More blood tests were orderd. His platelets were even lower. By Sunday arvo he was looking pretty pale and lethargic. He was pretty uncomfortable when weeing and it was found he had a fair bit of blood in his wee. Another two units of platelets were ordered to try and stop the bleeding. He was pretty flat and had a fair bit going on; gastro, chest infection and he was weeing blood. What else could happen? Sunday night his port was very red and swollen. The port was disconnected and an IV was inserted (after several attempts an anaesthetist was called!). He was ordered more bloods and it was confirmed the whole port line was infected. They quickly arranged for a cardiac review to eliminate heart involvement. Luckily the heart and conduit show no signs of infection. The plan is to try and save the line rather than surgically remove it. If this can't be done they will need to replace it (two more anaesthetics). Even though they are trying to save it, they will a low threshold because of the risks of more cardiac surgery.