Small Detour
We thought we were home free but our smooth sailing was interrupted on Thursday (Aug 10th) by some questionable fevers. Bash has been cutting his first molar and when he started feeling warm on our first night home we figured it was from teething. Overnight his temp continued to go up and down, never staying over 38.0 for long enough that we needed to call our oncologist. On the morning of the 10th he seemed happy and we decided to wait and see how his day went before calling and raising any unnecessary alarm bells. In the afternoon though he started spiking again and I felt it would be better to be safe than sorry and called our doctor. The doc asked us a lot of questions over the phone - ie, what was his highest temp, was he eating and drinking, still having wet diapers, etc. As he had thrown up his NG tube at bedtime the night before I was also a bit concerned that he wasn't drinking enough. The doctor decided he wanted us to come in and have him checked out to be safe and if anything re-inset the NG so that we could give him fluids if needed. We packed a bag for the hospital just in case and headed in.
When the doctors saw him they didn't think he seemed that unwell. His temp was 37.7, all his other vital signs seemed normal, and they decided to give him a fluid bolus since he was a bit mottled looking and they assumed he was a bit dehydrated. They also ordered blood work to check his electrolytes. Since he seemed to be drinking and eating ok we were given the option to wait on a re-insertion of the NG tube which we accepted. While he got his fluids his temp started to spike again and the nurses kept a close watch, but his temp came down again. The day doctor decided if his temp stayed down by the evening, and the night doctor assessed him and we got the all clear then we could go home. The night doctor came and Bash spiked to 38.2 and it was decided to draw blood cultures from each of his lumens on his broviac to test him for infections, start antibiotics as a precaution and admit us for the next 48 hours to see if he was 'cooking' anything. They draw blood from both lumens to determine if he has a line infection or if it is just in his body/blood. If it's a line infection it will only show up from one of the lumens. If this is the case then our doctor recommends removal of his broviac line to prevent a re-infection as the antibiotics may not treat an infection stuck to the inside of the line and he will continually get sick.
At the 7 hour mark Sebastian's cultures came back positive for an infection. He started a secondary antibiotic to hopefully cover him as they weren't sure what he was positive for yet. He had a pretty restless night and his temp in the morning of the 11th was 39.1. He was still happy though and eagerly flashed smiles at his nurses and played happily. He continued to take bottles and food so the NG was unnecessary. We could tell he was fighting something only because he was so tired and slept quite a bit. After that morning fever spike his temps returned to normal. The doctors continued to order blood work over the next few days to check for infection and at the 48 hour mark determined he had Streptococcus Salivarius a virus that is normally present in your body and considered harmless in a healthy individual. It showed up from both lines which are good signs it is in his body only and not in a line. His antibiotic orders were changed from Pip-tazo and Vancomycin to Ampicillin and he will get it through his broviac every 6 hours, alternating lines to help kill the bug just in case it is in both lines. The doctors said he can have daily passes in between his med and we should be looking at discharge again on Aug 25th.
This sucks, but we were expecting something to come up eventually and it is very common to spike fevers this soon after transplant. I'm glad my mommy instincts kicked in and I questioned the fevers as we were on the fence about it just being teething. I felt like I was being silly and over cautious, but doctors reassured me you cannot be too careful at this early stage. If we had waited he could have gotten way worse super fast and we could have been looking at sepsis and even an intensive care unit admission. I learned a valuable lesson from this, to always trust my gut no matter what anyone else thinks. Can't wait to bring our little guy home already! One day home was such a tease!
We thought we were home free but our smooth sailing was interrupted on Thursday (Aug 10th) by some questionable fevers. Bash has been cutting his first molar and when he started feeling warm on our first night home we figured it was from teething. Overnight his temp continued to go up and down, never staying over 38.0 for long enough that we needed to call our oncologist. On the morning of the 10th he seemed happy and we decided to wait and see how his day went before calling and raising any unnecessary alarm bells. In the afternoon though he started spiking again and I felt it would be better to be safe than sorry and called our doctor. The doc asked us a lot of questions over the phone - ie, what was his highest temp, was he eating and drinking, still having wet diapers, etc. As he had thrown up his NG tube at bedtime the night before I was also a bit concerned that he wasn't drinking enough. The doctor decided he wanted us to come in and have him checked out to be safe and if anything re-inset the NG so that we could give him fluids if needed. We packed a bag for the hospital just in case and headed in.
When the doctors saw him they didn't think he seemed that unwell. His temp was 37.7, all his other vital signs seemed normal, and they decided to give him a fluid bolus since he was a bit mottled looking and they assumed he was a bit dehydrated. They also ordered blood work to check his electrolytes. Since he seemed to be drinking and eating ok we were given the option to wait on a re-insertion of the NG tube which we accepted. While he got his fluids his temp started to spike again and the nurses kept a close watch, but his temp came down again. The day doctor decided if his temp stayed down by the evening, and the night doctor assessed him and we got the all clear then we could go home. The night doctor came and Bash spiked to 38.2 and it was decided to draw blood cultures from each of his lumens on his broviac to test him for infections, start antibiotics as a precaution and admit us for the next 48 hours to see if he was 'cooking' anything. They draw blood from both lumens to determine if he has a line infection or if it is just in his body/blood. If it's a line infection it will only show up from one of the lumens. If this is the case then our doctor recommends removal of his broviac line to prevent a re-infection as the antibiotics may not treat an infection stuck to the inside of the line and he will continually get sick.
At the 7 hour mark Sebastian's cultures came back positive for an infection. He started a secondary antibiotic to hopefully cover him as they weren't sure what he was positive for yet. He had a pretty restless night and his temp in the morning of the 11th was 39.1. He was still happy though and eagerly flashed smiles at his nurses and played happily. He continued to take bottles and food so the NG was unnecessary. We could tell he was fighting something only because he was so tired and slept quite a bit. After that morning fever spike his temps returned to normal. The doctors continued to order blood work over the next few days to check for infection and at the 48 hour mark determined he had Streptococcus Salivarius a virus that is normally present in your body and considered harmless in a healthy individual. It showed up from both lines which are good signs it is in his body only and not in a line. His antibiotic orders were changed from Pip-tazo and Vancomycin to Ampicillin and he will get it through his broviac every 6 hours, alternating lines to help kill the bug just in case it is in both lines. The doctors said he can have daily passes in between his med and we should be looking at discharge again on Aug 25th.
This sucks, but we were expecting something to come up eventually and it is very common to spike fevers this soon after transplant. I'm glad my mommy instincts kicked in and I questioned the fevers as we were on the fence about it just being teething. I felt like I was being silly and over cautious, but doctors reassured me you cannot be too careful at this early stage. If we had waited he could have gotten way worse super fast and we could have been looking at sepsis and even an intensive care unit admission. I learned a valuable lesson from this, to always trust my gut no matter what anyone else thinks. Can't wait to bring our little guy home already! One day home was such a tease!
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