D+36: Up your nose with a rubber hose

WBC: 1.0
ANC: 520

Ryan was a lot more comfortable today. I'd like to attribute this to a clearing viral infection, but I'm afraid it's probably just the cumulative effect of the increased morphine dose. Of course, that's nothing to complain about. Cheryl and I are both happy that Ryan seems to be feeling less discomfort now.

We are still trying to figure out the source of Ryan's discomfort and bloody urine. A bunch of labs came back today that ruled out bacterial infections, so it looks like we are dealing with a virus. If you remember from Cheryl's earlier post, some labs were drawn on Monday to test for two of the most likely culprits: BK virus and adenovirus. Well, it looks like the urine was not collected and/or processed correctly, so we get to start all over tomorrow. Now we won't know until Thursday which virus Ryan has. It's not super-important from a treatment standpoint, since both viruses are essentially treated the same way, but Cheryl and I like to know so we can focus our anxiety accordingly. Speaking of viral tests, Ryan came back negative today for the HHV-6 that was stifling his counts last week. Nice to scratch one off of the list for a change. Then again, perhaps it was just being polite -- moving aside so that Ryan's new virus can take hold.

Ryan has been battling a fever off and on for the last 24 hours. It comes and goes, so hopefully it's just transient weirdness and not something else. His pulse has also been quite high over the past day or two -- occasionally jumping up into the 200+ range. Dr. Graham thinks he may have a little fluid around his heart, which can cause this type of rate jump. An echocardiogram is scheduled for tomorrow to check things out.

Since the beginning of this process, Cheryl and I have struggled with the decision of whether or not Ryan needed an NG tube to help take oral medication. As it turned out, he dominated the early stages of treatment, defiantly sucking down the chemo drugs and liking them! Things are a bit different these days, however. Ryan's throat is really torn up from parainfluenza and the aftermath of mucositis. Add to that his typical level of sedation (heavy), and you can see how it might be difficult to administer oral meds at this point. So, we finally took the plunge and had a feeding tube inserted today. It's basically a plastic straw that they insert into your nose and run down to your stomach. Ryan did very well during the procedure and actually helped things along by swallowing at the appropriate times. We're hoping that we will only need it for the next week or so.